International Journal of Mental Health Nursing最新文献

{"title":"Experienced Nurses' Provision of Compassionate Care to Individuals Experiencing Alcohol-Related Harm: A Qualitative Study of a Nurse-Led Alcohol Harm-Reduction Approach","authors":"Takaomi Furuno,&nbsp;Narumi Fujino,&nbsp;Yuji Fujimoto,&nbsp;Naoko Hirahara,&nbsp;Nozomi Furuno","doi":"10.1111/inm.70257","DOIUrl":"10.1111/inm.70257","url":null,"abstract":"<div>\u0000 \u0000 <p>This study aimed to explore how experienced nurses provide compassionate care to individuals experiencing alcohol-related harm, as well as examine approaches to recovery support in addiction nursing from a harm-reduction perspective. Semi-structured interviews were conducted with nine nurses in Japan; the respondents had extensive experience in providing nursing care to individuals with alcohol use disorder. The data were transcribed verbatim and analysed using reflexive thematic analysis. The thematic analysis yielded three themes regarding compassionate care provided by experienced nurses: (1) attempting to alleviate life-related distress and support social well-being; (2) building a secure base to support recovery; and (3) supporting the reformation of identity destabilised by alcohol use. Rather than focusing on drinking behaviour, the nurses focused on individuals' lived difficulties and suffering and provided realistic support without coercion. Moreover, even when relapse or setbacks occurred, nurses did not sever relationships; they continued treatment by ensuring that the individuals could always return to healthcare institutions for support. Overall, this study revealed that experienced nurses support the reconstruction of life narratives (re-storying) by integrating harm reduction, the concept of a secure base, and recovery-oriented practice through relationships. These findings present a relationship-centred recovery process model in addiction nursing that is not limited to abstinence outcomes. This proposed model may be utilised as a guide for novice nurses' education and clinical practice.</p>\u0000 </div>","PeriodicalId":14007,"journal":{"name":"International Journal of Mental Health Nursing","volume":"35 2","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147655273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing the Therapeutic Relationship Between Mental Health Case Managers and Individuals With Serious Mental Health Conditions: A Participatory Action Research Study in Community-Based Services","authors":"Martí Subías-Miquel,&nbsp;Ana Ventosa Ruiz,&nbsp;Sara Sánchez-Balcells,&nbsp;Hilari Andrés Mora,&nbsp;Maria Romeu Labayen,&nbsp;Montserrat Puig Llobet,&nbsp;Antonio Moreno-Poyato","doi":"10.1111/inm.70256","DOIUrl":"10.1111/inm.70256","url":null,"abstract":"<p>This study examined how community mental health case managers, most of whom were mental health nurses, modified their day-to-day practice to strengthen the therapeutic relationship within community services. Using a participatory action research design across 10 centres in Catalonia, Spain, 24 case managers and 105 patients engaged in two action-reflection cycles. Data from reflective diaries and focus groups were analyzed using inductive thematic analysis. Through cyclical observation and collaborative reflection, participants identified key facilitators and barriers to developing the therapeutic relationship and co-designed two practice innovations: (1) jointly-created informational materials clarifying case-management scope and expectations, and (2) regular mixed patient-professional reflective groups focused on the therapeutic process. Despite structural pressures, heavy workloads, service fragmentation, and limited opportunities for professional reflection, the participatory approach supported sustainable, relationally focused practice change grounded in patient-provider dialogue. Embedding structured reflective spaces within routine care emerged as a practical mechanism to consolidate therapeutic alliance and advance recovery-oriented practice. While findings apply across disciplines, they are particularly relevant to nursing-led and nurse-participating case-management teams, in which continuous therapeutic contact, coordination functions and relational expertise intersect. The study offers a replicable framework for enhancing person-centred care in community mental health settings, and it underscores the value of nurse-involved co-creation and structured reflection to maintain therapeutic presence, align expectations and integrate lived experience into ongoing quality improvement.</p>","PeriodicalId":14007,"journal":{"name":"International Journal of Mental Health Nursing","volume":"35 2","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13061650/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147641141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mental Health Promotion Through Nursing Interventions Focused on Anxiety, Sleep and Well-Being: A Scoping Review","authors":"Louise Constancia de Melo Alves Silva,&nbsp;Samia Valeria Ozorio Dutra,&nbsp;Barbara Fernandes Ferreira,&nbsp;Yenifer Lizeth Gañan Rojas,&nbsp;Kauanny Vitoria Gurgel dos Santos,&nbsp;Carlos Jordão Assis de Silva,&nbsp;Hylarina Maria Montenegro Diniz Silva,&nbsp;Kátia Regina Barros Ribeiro,&nbsp;Daniele Vieira Dantas,&nbsp;Rodrigo Assis Neves Dantas","doi":"10.1111/inm.70254","DOIUrl":"10.1111/inm.70254","url":null,"abstract":"<p>Anxiety is more prevalent than other mental disorders and maintains a bidirectional relationship with sleep disturbances, negatively affecting well-being and overall mental health. This scenario underscores the need to strengthen and qualify nursing practice in addressing these outcomes. This study aimed to map how nursing has developed care for adults and older people through interventions related to anxiety, sleep quality and well-being. A scoping review was conducted in accordance with the PRISMA-ScR checklist. Searches were performed between November and December 2025 across 11 data sources: CINAHL, Cochrane Library, LILACS, MEDLINE/PubMed, SciELO, Scopus, EBSCO Open Dissertations, Web of Science, CAPES Catalogue of Theses and Dissertations, ScienceDirect and Google Scholar, in addition to reference list screening. Sixty-four studies were included. Although the search covered the period from 2010 to 2025, eligible publications were identified between 2011 and 2025, predominantly clinical trials conducted in Iran and Turkey. Thirty-one occurrences of interventions were identified, representing different modes of application of a smaller set of nursing-implementable strategies targeting anxiety, sleep and well-being. Integrative and complementary therapies predominated, including aromatherapy, music therapy, reflexology, acupressure, therapeutic touch, massage, relaxation techniques, Reiki and yoga. Other interventions comprised spiritual support, environmental adjustments (lighting, noise, temperature control), guided imagery, group counselling and self-care programmes, reinforcing nursing's holistic approach. Sleep quality was the most investigated outcome, mainly through environmental control during hospitalisation. However, considering sleep, well-being and anxiety, multicentre studies, further investigation into spirituality and the nursing process and research prioritising well-being and anxiety disorders as primary outcomes are still needed.</p>","PeriodicalId":14007,"journal":{"name":"International Journal of Mental Health Nursing","volume":"35 2","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13061651/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147641191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Development of a New Mental Health Pre-Registration Nursing Curriculum: Reclaiming Professional Identity and Field Specific Content","authors":"Jane Fisher,&nbsp;Simon Baverstock,&nbsp;Gareth Bell,&nbsp;Jayne Firestone,&nbsp;April Ingleby,&nbsp;Julie McCartney,&nbsp;Eve Potts,&nbsp;Diane Roberts,&nbsp;Michael Smith,&nbsp;Donna Steele","doi":"10.1111/inm.70255","DOIUrl":"10.1111/inm.70255","url":null,"abstract":"<p>This paper outlines the design and development of a 3-year undergraduate pre-registration mental health nursing curriculum in the United Kingdom. It resists the trend towards generic nurse education, reclaims mental health field-specific identity and equips future nurses with the knowledge, skills and values to meet the complex mental health needs of contemporary populations. International literature reflects growing concern over the dilution of mental health nursing knowledge and the erosion of professional identity, largely attributed to generic curriculum models and standardised regulatory frameworks. Critics argue that the dominance of adult-centric education compromises field-specific learning, perpetuating a theory–practice gap and leaving graduates underprepared for mental health practice. Calls for reform have intensified globally, yet practical examples of curriculum redesign to address these issues remain limited. Issues were approached through a comprehensive review and redesign of the current mental health nursing curriculum considering relevant pedagogical theory and international critiques of genericism in nursing education. The authors, as academic leads for the curriculum redesign, embedded field-specific modules, innovative assessments, restorative supervision and mental health-focused simulation. Heutagogy informed the pedagogical framework, aiming to produce self-determined, critically reflexive practitioners. The redesigned curriculum challenges genericism and reinstates mental health-specific content, with assessments and simulations contextualised to authentic practice. This approach strengthens professional identity, reduces reliance on artificial intelligence generated work through dialogical assessments and promotes critical thinking essential for ethical, person-centred care. Future evaluation will focus on student retention, satisfaction and preparedness for practice.</p>","PeriodicalId":14007,"journal":{"name":"International Journal of Mental Health Nursing","volume":"35 2","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13054460/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147629599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Neuroplastic Narrative and Neuro-Ecological Diversity: Non-Pathologizing Biological Foundations for Trauma-Informed Medical and Mental Health Nursing","authors":"Haley Peckham,&nbsp;Bridget Hamilton","doi":"10.1111/inm.70248","DOIUrl":"10.1111/inm.70248","url":null,"abstract":"<p>Following the Adverse Childhood Experiences study (1998), a wealth of similar studies has strongly associated experiences of trauma and adversity in childhood with increased risk of poor physical and mental health and undesirable social outcomes in adulthood. The medical model interprets this data through a pathologizing lens which assumes that trauma and adversity are harmful and lead to impairment and pathology. Trauma-informed and Adverse Childhood Experience aware approaches can perpetuate this pathologizing framing, despite prioritising asking “What's happened to you?” over “What's wrong with you?” In this paper, we draw on <i>The Neuroplastic Narrative</i>, a novel, non-pathologizing biological theory which foregrounds people's adaptation to their ecological niche. This narrative offers a compelling reinterpretation of data that associates early trauma and adversity with poor adult health and social outcomes. We introduce an evolutionary perspective, Life History Theory, to reframe the Adverse Childhood Experiences (ACEs) study through an evolutionary lens, yielding the insight that populations with ACEs strategically adapt to their environment. We evidence the perspective that the human species' capacity to adapt to a diverse range of environments during development is strategic and not of itself pathological. Adapting to diverse ecologies produces commensurately diverse brains and physiologies. We term the diversity across brains and physiologies resulting from adapting to experiences: <i>Neuro-ecological diversity</i> An ecological framing that privileges experiences and considers how and why people adapt to traumatising relationships and adverse environments both physiologically and behaviourally calls for novel formulations and responses from practitioners and ultimately for a non-pathologizing foundation for trauma-informed nursing. This less shaming response also orientates our attention towards issues of inequity and social justice. The aim of this position paper is to articulate a trauma-informed framework for nursing that does not focus on pathology but rather on adaptation, offering nurses a new way to understand, formulate and respond to distress and suffering associated with trauma and adversity. We will demonstrate that trauma-informed nursing needs a foundation that is not premised in pathology but honours experience; offer the Neuroplastic Narrative as a biological, non-pathologizing (less shaming) foundation for trauma informed nursing, and introduce the concept of Neuro-Ecological Diversity to support nurses' understandings of, and responses to, different consumer presentations.</p>","PeriodicalId":14007,"journal":{"name":"International Journal of Mental Health Nursing","volume":"35 2","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13039764/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147597205","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Qualitative Study of Psychiatric Nurses' Experience of Work Alienation","authors":"Lan Wang,&nbsp;Changhong Chen,&nbsp;Yan Zhang,&nbsp;Li Pang,&nbsp;Zizhen Huang,&nbsp;Zhijiao Zhao,&nbsp;Yongfang Wang,&nbsp;Qun Ma,&nbsp;Gaoqi Zhang,&nbsp;Xiumei Hou,&nbsp;Zhongli Shi","doi":"10.1111/inm.70253","DOIUrl":"10.1111/inm.70253","url":null,"abstract":"<div>\u0000 \u0000 <p>Work alienation is a significant contributing factor to turnover behaviour among nurses. Psychiatric nurses, in particular, face considerable stigmatization, underscoring the need for greater attention to their mental health. The purpose of this study is to explore the experiences of work alienation among psychiatric nurses and to offer insights and references for alleviating their sense of alienation, promoting workforce stability, and informing the development of targeted intervention programs. A phenomenological research approach was employed to select 14 nursing staff members from a tertiary A-level psychiatric hospital in Shandong Province, using purposive sampling between July and October 2024. Face-to-face semi-structured interviews were conducted, and the Colaizzi 7-step analysis method was used to organize the data and refine the themes. A total of four overarching themes and nine sub-themes were identified: physical and psychological symptoms (psychological symptoms, physical symptoms), coping styles (self-concealment, support-seeking), cumulative impacts (burnout, self-growth), and support needs (individual support, organizational support, social support). The phenomenon of work alienation among psychiatric nurses is a complex and multifaceted issue that requires focused attention from both nursing professionals and healthcare administrators. Early identification of work alienation trends is crucial, along with the implementation of targeted interventions aimed at safeguarding the physical and mental well-being of psychiatric nurses.</p>\u0000 </div>","PeriodicalId":14007,"journal":{"name":"International Journal of Mental Health Nursing","volume":"35 2","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147577332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Game Changers in the Treatment of and Engagement With Persons Living With Mental Health and Substance Use Disorders: The Role of the Nurse","authors":"Arlene Kent-Wilkinson,&nbsp;Sudor Ogunwemimo,&nbsp;Eileen Zaba","doi":"10.1111/inm.70251","DOIUrl":"10.1111/inm.70251","url":null,"abstract":"<p>The game changers in mental health and substance use disorder treatment have been shaped by historical sea changes marked by transformative advancements that have significantly enhanced patient care. Breakthroughs in psychotherapy, psychosurgery and psychopharmacology have each contributed to reshaping clinical practices, especially the revolutionary discovery of psychotropics. More recently, the rapid development of artificial intelligence has begun to address long-standing barriers in access to care for individuals experiencing mental health and substance use disorders. Transitioning from past eras characterised by institutionalisation and inhumane treatment, the field of mental health and substance use has embraced a more holistic, patient-centred and community-based approach. Landmark legislation and progressive policy frameworks have played a vital role in safeguarding the rights and dignity of individuals living with mental health and substance use disorders. Patient engagement, the cornerstone of effective treatment, continues to evolve alongside the expansion of therapeutic options, from patients having no autonomy over decisions to encouraging clients to make informed decisions about their care. Within this dynamic landscape, nurses serve as essential gatekeepers of the healthcare system, providing critical functions such as clinical assessment, medication administration, patient education, counselling and ongoing monitoring to mitigate adverse treatment outcomes and support recovery, while establishing a therapeutic relationship in all aspects of care. This historical discussion paper explores and summarises the key game changer events by highlighting the treatment and engagement of persons living with mental health and substance abuse disorders of the past in timeline periods. Predictions for the future are also projected to encourage reflections of the past and thought-provoking acumens for the future.</p>","PeriodicalId":14007,"journal":{"name":"International Journal of Mental Health Nursing","volume":"35 2","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13032119/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147535318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Personal and Societal Recovery in Depression—A Qualitative Study","authors":"Annelot van Geffen,&nbsp;Dorien Smit,&nbsp;Janna N. Vrijsen,&nbsp;Jan Spijker","doi":"10.1111/inm.70247","DOIUrl":"10.1111/inm.70247","url":null,"abstract":"<p>There is growing attention for personal and societal recovery in mental health care. Existing research in this area is primarily focused on populations with Severe Mental Illness (SMI), while the development of personal and societal recovery in depression remains largely unstudied. This study explored the development of personal and social recovery, barriers and facilitators, and ways in which the recovery process can be supported for people with depression. Fourteen semi-structured interviews were conducted with individuals who experienced at least two episodes of depression and were in remission at the time of the interview (except for two deviant cases). Data were analysed using a constructivist grounded theory (CGT) informed approach combined with elements of reflexive thematic analysis (RTA). Purposeful sampling was applied to gather a heterogenous sample and data collection continued until theoretical saturation was reached. COREQ guidelines were followed. Participants described personal recovery as an intrapersonal, retrospective process of self-discovery. Societal recovery was described as an interpersonal, prospectively oriented process centred around developing belonging. These processes are bi-directional, as societal recovery created further opportunities for personal recovery. Participants described a preliminary step of ‘societal participation’ involving low demanding tasks to rebuild functional capacity and self-esteem. During personal recovery, participants need empathetic support which transitions to pragmatic support as individuals progress towards societal recovery. Our findings underscore the interrelatedness of personal recovery and societal recovery. Self-insight, developed through personal recovery, is applied during societal recovery. This occurs through the alignment of activities with personal values and meaning. Belonging in society through meaningful participation is what drives people towards societal recovery. Societal recovery often develops through an important step of societal participation.</p>","PeriodicalId":14007,"journal":{"name":"International Journal of Mental Health Nursing","volume":"35 2","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13003010/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147489020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Distress, Discomfort and Moral Injury: Emergency Department Clinicians Experiences Caring for People With a Psychosocial Disability and a National Disability Insurance Scheme Plan","authors":"Heather McIntyre,&nbsp;Mark Loughhead,&nbsp;Laura Hayes,&nbsp;Anit Manudhane,&nbsp;Caroline Allen,&nbsp;Dean Barton-Smith,&nbsp;Brooke Bickley,&nbsp;Louis Vega,&nbsp;Jewels Smith,&nbsp;Ursula Wharton,&nbsp;Nicholas Procter","doi":"10.1111/inm.70249","DOIUrl":"10.1111/inm.70249","url":null,"abstract":"<p>People with a psychosocial disability (PSD) and a National Disability Insurance Scheme (NDIS) plan may at times require emergency care. This study aimed to gather evidence of current practice and experiences from the perspective of emergency department clinicians that care for people with a PSD and an NDIS plan. A national anonymous survey was conducted between December 2022 and June 2023. Emergency department (ED) clinicians who had attended to a person with a PSD and an NDIS plan in the ED within the last 2 years were able to participate in the study. The COREQ standards were used for reporting. Results of this qualitative online survey, conducted nationally in Australia, were thematically analysed. Experiences of ED clinicians when caring for people with PSD and an NDIS plan, plus perspectives about care, communication and continuity of care are discussed. Themes generated were: <i>System and service drivers</i>: <i>who cares for whom? And when?</i>; <i>Providing care in pressured environments</i>; <i>Connect the service silos</i>; <i>Inclusion of carers/support workers</i>. This study provides new information on clinician experience's when caring for people with psychosocial disability and an NDIS plan in the ED and information about system challenges, limitations and inability to comply with fundamentals of care.</p>","PeriodicalId":14007,"journal":{"name":"International Journal of Mental Health Nursing","volume":"35 2","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13000669/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147482826","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of a Repeat Suicide Risk Management Protocol for Emergency Department Patients With Suicide Attempts: An Exploratory Sequential Mixed-Methods Study","authors":"Rong Tan,&nbsp;Fen Teng,&nbsp;Jia-Qing Wang,&nbsp;Yun-Dan Wang,&nbsp;Le-Cheng Li,&nbsp;De-Ying Hu","doi":"10.1111/inm.70252","DOIUrl":"10.1111/inm.70252","url":null,"abstract":"<p>The emergency department serves as the first point of contact for patients who have attempted suicide, playing a crucial role in identifying and managing their risk of subsequent suicide behaviours. However, evidence-based protocols for managing the repeat suicide risk are currently lacking in Chinese emergency departments. This study aimed to develop a preliminary, evidence-informed protocol for managing repeat suicide risk among emergency department patients who have already attempted suicide. A two-phase exploratory sequential mixed-methods design was employed. Phase 1 involved evidence synthesis and semi-structured interviews to develop a preliminary protocol draft. Phase 2 utilized a two-round Delphi expert consultation to revise and finalize the protocol. In the first phase, three themes were identified: behavioural attitudes toward suicide prevention, subjective norms of significant others and perceived behavioural control among healthcare providers. In the second phase, 19 experts completed two rounds of Delphi consultation. This resulted in a consensus protocol with 4 primary indicators (organiszational support, safety assurance, suicide assessment and intervention measures), 12 secondary indicators and 38 tertiary indicators. The expert panel demonstrated good authority and coordination (Cr = 0.927, Ca = 0.958), achieving a high level of consensus (Kendall's W = 0.292 and 0.385, <i>p</i> &lt; 0.001) across two rounds. The risk management protocol developed in this study is actionable and focused. It provides a valuable reference for future clinical practice and related research in managing repeat suicide risk among such patients.</p>","PeriodicalId":14007,"journal":{"name":"International Journal of Mental Health Nursing","volume":"35 2","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13003008/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147489044","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}