International Journal of Mental Health Nursing最新文献

{"title":"Realising the Convention on the Rights of Persons With Disabilities With Mental Health Advance Directives","authors":"Sarah Gordon,&nbsp;Armon Tamatea,&nbsp;Katey Thom,&nbsp;Anthony O'Brien,&nbsp;Giles Newton-Howles,&nbsp;Jessie Lenagh-Glue,&nbsp;Johnnie Potiki,&nbsp;Paul Glue","doi":"10.1111/inm.70237","DOIUrl":"10.1111/inm.70237","url":null,"abstract":"<div>\u0000 \u0000 <p>All countries that have signed the United Nations Convention on the Rights of Persons with Disabilities (CRPD) have obligations to align their national laws and policies with it. According to the General Comment on Article 12 prepared by the CRPD Committee, this entails operationalising systems and practices that support, rather than substitute, decision-making. The CPRD Committee has identified Mental Health Advance Directives (MHADs) as one mechanism to operationalise supported decision-making, and many jurisdictions have incorporated them into newly reformed mental health legislation. The purpose of this systematic scoping review was to assess whether any MHADs currently under investigation conform to the specifications outlined in the General Comment on Article 12 regarding advance directives. The results indicated that no MHAD under investigation in the international literature meets the specifications of the General Comment on Article 12 for advance directives. MHADs are an essential tool to ensure the human rights of people who experience psychosocial disability are protected in line with the requirements of the CRPD. Although there are projects examining the effectiveness of MHADs, none of these MHADs fulfil the specifications of the General Comment on Article 12. This raises questions for both policymakers and clinicians who will implement these MHADs, particularly as they feature in newly reformed legislation. Researchers should consider the implications of the CRPD Committee guidance when evaluating the effectiveness of MHADs, including whether their jurisdiction aligns with the requirements for tools that facilitate supported decision-making.</p>\u0000 </div>","PeriodicalId":14007,"journal":{"name":"International Journal of Mental Health Nursing","volume":"35 2","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147446631","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":"Informal Coercion Experienced by Adolescents in Mental Health Care—A Systematic Review","authors":"Tiina Överlund,&nbsp;Tella Lantta","doi":"10.1111/inm.70245","DOIUrl":"10.1111/inm.70245","url":null,"abstract":"<p>Adolescents are a developmentally vulnerable group in mental health care, yet their experiences of informal coercion remain underexplored. Most existing research reflects adult perspectives, leaving a gap in understanding how adolescents experience such practices. This review synthesises qualitative evidence on the forms and consequences of informal coercion experienced by adolescents in mental health settings. The review followed the PRISMA guidelines and was registered in PROSPERO. A systematic search was conducted across seven databases in February 2025 (PubMed, CINAHL, PsycINFO, EMBASE, Scopus, Web of Science, Cochrane Library). Screening and inclusion were performed using Covidence supplemented by manual reference searches. Qualitative content analysis was applied, using a framework informed by previously identified forms of informal coercion. Across 12 studies, informal coercion shaped adolescents' involvement in mental health care. Predominant forms included treatment pressure, silencing and exclusion and appealing to rules and routines, accompanied by threats or disciplinary control. These practices were experienced as undermining autonomy and trust. The adolescents responded through adaptive and resistant coping strategies, such as compliance, concealment, or overt opposition. The experiences were commonly associated with emotional distress, relational mistrust and hindered recovery, although some adolescents interpreted structured pressure as supportive or protective. Informal coercion is present and consequential in adolescent mental health care. Existing adult-based conceptualisations may overlook its relational and subtle nature. Further research is needed to explain how informal coercion is constructed in interactions and how it is justified in adolescent mental health care. Such knowledge is essential for developing ethically sound, rights-respecting nursing practices.</p><p><b>Trial Registration:</b> PROSPERO: CRD42025644678</p>","PeriodicalId":14007,"journal":{"name":"International Journal of Mental Health Nursing","volume":"35 2","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12982914/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147446491","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":"Reflections on Women and Seclusion in Forensic Mental Health Services","authors":"Martin Locht Pedersen,&nbsp;Frederik Alkier Gildberg","doi":"10.1111/inm.70243","DOIUrl":"10.1111/inm.70243","url":null,"abstract":"","PeriodicalId":14007,"journal":{"name":"International Journal of Mental Health Nursing","volume":"35 2","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147313518","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":"Dismantling the Diagnostic Construct of Borderline Personality Disorder: A Critical Discourse Analysis","authors":"Laurence Cobbaert,&nbsp;Ellen Maloney,&nbsp;Keir Harding,&nbsp;Sandi James","doi":"10.1111/inm.70241","DOIUrl":"10.1111/inm.70241","url":null,"abstract":"<p>Borderline personality disorder (BPD) is widely presented as an objective psychiatric diagnosis describing emotional and relational distress. However, feminist, decolonial, neurodiversity and lived experience-led scholarship demonstrates that BPD emerged within colonial, cisheteronormative, misogynist and neuronormative epistemologies that moralise distress and regulate identity, self-expression and access to care. This paper critically examines BPD as a diagnostic construct and governance technology that produces iatrogenic harm through epistemic injustice, structural exclusion and moralised interpretations of need. It explores how the diagnosis discredits lived experience knowledge, justifies care withdrawal and obscures sensory, cultural and structural determinants of distress and considers the implications for mental health nursing practice. A critical discourse analysis was conducted across psychiatric literature, policy documents, historical diagnostic texts and lived experience scholarship, treating psychiatric language and categorisation as technologies of power shaping credibility and clinical response. The analysis shows that BPD operates less as a clinical description than as a regulatory framework maintained through gendered, colonial and cisheteronormative norms. Dominant narratives of dependence, attachment theory and emotional expression obscure trauma, sensory differences and structural violence, while legitimising coercive and exclusionary practices. Mental health nurses are positioned at the frontline of enacting these logics, often experiencing moral distress. The BPD diagnosis lacks epistemic, cultural and ethical legitimacy. Its continued use undermines therapeutic safety and trust. A harm reduction transition away from the BPD construct is required, prioritising relational safety, sensory-informed and culturally responsive care, epistemic humility and lived experience leadership.</p>","PeriodicalId":14007,"journal":{"name":"International Journal of Mental Health Nursing","volume":"35 2","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12936405/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147313568","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":"Beyond Self-Stigma in Bipolar Disorder: Self-Compassion as a Target for Mental Health Nursing Interventions—Conditional Indirect Effects by Treatment Adherence and Age","authors":"Erman Yıldız,&nbsp;Gamze Örüm","doi":"10.1111/inm.70239","DOIUrl":"10.1111/inm.70239","url":null,"abstract":"<div>\u0000 \u0000 <p>Self-stigma profoundly impacts psychological well-being in individuals with bipolar disorder, yet the mechanisms underlying this relationship remain unclear. This study examined whether self-compassion mediates the relationship between self-stigma and psychological well-being, whether treatment adherence moderates this mediating pathway, and whether age moderates the direct relationship. A cross-sectional study was conducted with 121 outpatients diagnosed with Bipolar Type I Disorder receiving care at two hospitals in Eastern Türkiye between January 2024 and February 2025. Participants completed validated measures of self-stigma, self-compassion, and psychological well-being during clinical remission. Data were analysed using mediation, moderated mediation, and simple moderation models with bootstrap procedures. Self-stigma demonstrated a strong negative total effect on well-being. Self-compassion partially mediated this relationship, explaining 27% of the total effect. Critically, moderated mediation analysis revealed that treatment adherence significantly altered the strength of this mediating pathway. Among individuals with poor treatment adherence, self-stigma more severely compromised self-compassion, resulting in a substantially stronger indirect effect on well-being compared to those with good adherence. The difference between these conditional indirect effects was statistically significant. Additionally, age moderated the direct relationship between self-stigma and well-being, with younger adults showing greater vulnerability than older adults, though age did not moderate the self-compassion pathway. These findings identify self-compassion as a key but conditionally effective protective mechanism against self-stigma. Treatment adherence emerges as a critical factor that preserves this protective mechanism, suggesting that adherence promotion represents both a clinical and psychosocial intervention target for mental health nurses.</p>\u0000 </div>","PeriodicalId":14007,"journal":{"name":"International Journal of Mental Health Nursing","volume":"35 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146230328","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":"Risk Redux? Therapeutic Risk Taking and the Role of Supported Decision Making in Mental Health Settings","authors":"Helen P. Hamer,&nbsp;Debra Lampshire,&nbsp;Katey Thom,&nbsp;Daniel Sutton,&nbsp;Gillian MacIntyre,&nbsp;Nicola Cogan","doi":"10.1111/inm.70234","DOIUrl":"10.1111/inm.70234","url":null,"abstract":"<p>The prevailing culture of risk aversion and defensive practice within mental health systems significantly undermines recovery and well-being. In response, many Western jurisdictions are undergoing a fundamental transformation of mental health legislation, shifting towards a human rights-based approach. This transition emphasises supported decision-making, a reduction in coercive practices, and a stronger focus on recovery-oriented care. As services shift towards being human rights-led, clinicians need to move from making decisions for individuals in their best interests to considering what support is required to enable people to make their own choices; a difficult shift within services that remain risk-averse within a substitute decision-making regime. This paper reconceptualises risk not solely as a threat to be managed, but as a potential catalyst for recovery and empowerment. The authors call for a movement away from defensive, risk-averse models towards defensible and considered practices that thoughtfully balance safety with individual autonomy. At the heart of this shift is the innovative <i>Dimensions of Safety</i> framework, which assists practitioners in navigating complex decision-making processes while aligning their approaches with both human rights principles and the person's right to self-determination. This framework encourages therapeutic risk-taking as a means of fostering personal growth, resilience and empowerment. Furthermore, it incorporates cultural and spiritual dimensions to ensure care is equitable and inclusive. A trauma-informed perspective is also central, recognising the impact of past adversity on current mental health and decision-making skills. By challenging the dominance of substituted decision-making and promoting collaborative, rights-based care, this framework offers a practical and ethical pathway towards mental health systems that are safer, more inclusive and genuinely supportive of recovery and autonomy.</p>","PeriodicalId":14007,"journal":{"name":"International Journal of Mental Health Nursing","volume":"35 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12915700/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146222732","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":"Organisation and Practice of Crisis Resolution Teams in Adult Mental Health Services in Norway: A National Survey","authors":"Torleif Ruud,&nbsp;Bengt Karlsson,&nbsp;Trude Klevan,&nbsp;Nina Hasselberg","doi":"10.1111/inm.70238","DOIUrl":"10.1111/inm.70238","url":null,"abstract":"<div>\u0000 \u0000 <p>Crisis resolution teams (CRTs), which aim to reduce acute admissions to mental health inpatient units, have been the subject of studies on practice, effects and service user experiences. However, such studies involve a limited proportion of the CRTs. National surveys are necessary to understand the large-scale implementation of CRTs. The aims of this survey were to describe the organisation and practices of Norwegian CRTs as reported by team managers. An online questionnaire was sent to team managers of all 56 CRTs in mental health services for adults in Norway in 2013. The response rate was 100%. Findings were compared to national recommendations for CRTs in Norway and to findings from a similar survey in England. CRTs were available for 90% of the Norwegian adult population. Significant variations in team composition and practices indicated differences in CRT services provided across teams, and CRTs were not assigned the role of gatekeeping acute inpatient admissions. Unlike in England, Norwegian CRTs served a broader range of service users than just those who would otherwise require admission to an acute mental health inpatient unit. CRTs showed partial adherence to national recommendations and even less compared to English CRTs and the CRT model in international literature. High adherence to the CRT model would require more specific national recommendations, adequate staffing and training, and for CRTs to be given the resources and authority to act as gatekeepers for acute inpatient admissions.</p>\u0000 </div>","PeriodicalId":14007,"journal":{"name":"International Journal of Mental Health Nursing","volume":"35 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146215166","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":"Psychometric Evaluation of the Competence Scale in Managing Behavioural and Psychological Symptoms of Dementia (CS-MBPSD) for Care Workers","authors":"Jun-Ah Song,&nbsp;Hongjin Cheon,&nbsp;Yoosun Yang,&nbsp;JeongLan Kim,&nbsp;YunHee Lee,&nbsp;Soyeong Oh,&nbsp;Jung Bok Lee","doi":"10.1111/inm.70227","DOIUrl":"10.1111/inm.70227","url":null,"abstract":"<div>\u0000 \u0000 <p>The aim of this study was to evaluate the validity and reliability of the competence scale in managing behavioural and psychological symptoms of dementia for care workers. A methodological study design was used. Data were collected from 180 care workers in long-term care facilities between December 1 and December 26, 2022. Confirmatory factor analysis was conducted to examine the dimensionality of the scale and support construct validity. Construct validity was assessed through convergent and discriminant validity. Concurrent validity was evaluated using correlations with dementia attitudes, self-efficacy and caregiver burden scales. Internal consistency tests were performed to assess reliability. The confirmatory factor analysis showed reasonable model fit indices. Evidence for convergent validity was supported by satisfactory standardised factor loadings, average variance extracted values and composite reliability values, except for one item. Discriminant validity was demonstrated between all constructs. Concurrent validity showed strong positive correlations with dementia attitudes and self-efficacy scales and a negative correlation with caregiver burden. The instrument exhibited strong validity, high reliability and reasonable model fit. The results provide initial psychometric support for the competence scale in managing behavioural and psychological symptoms of dementia among care workers with basic dementia care training.</p>\u0000 </div>","PeriodicalId":14007,"journal":{"name":"International Journal of Mental Health Nursing","volume":"35 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146168476","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":"Healthcare Interventions to Support Informal Caregivers of People With Severe Mental Illnesses: A Scoping Review","authors":"Marjolijn Heslinga,&nbsp;Marie Louise Luttik,&nbsp;Bouwina Esther Sportel,&nbsp;Evelyn Finnema,&nbsp;Nynke Boonstra","doi":"10.1111/inm.70236","DOIUrl":"10.1111/inm.70236","url":null,"abstract":"<p>In recent years, care for people with severe mental illnesses (SMI) has shifted from institutional to recovery-based treatment in which informal caregivers often have an important role. However, their increased involvement has elevated issues such as role strain or burden of care, which indicates that they need greater support. Adding to existing reviews, this study is intended to provide an overview of interventions that support informal caregivers who are tending to people with severe depression, anxiety or personality disorders other than borderline personality disorder (BPD). A scoping review, following the JBI guidelines, was performed. Pubmed, PsycInfo, CINAHL, Embase and Cochrane Library were searched using the keywords ‘caregiver’, ‘SMI’, ‘support’, ‘interventions’ and related terms, which led to 21 720 references. After removing duplicates (<i>n</i> = 9043) and screening titles, abstracts (<i>n</i> = 12 677) as well as full-text (<i>n</i> = 108) for inappropriate results, 13 articles met the inclusion criteria and are included in this review. The included articles describe 11 different interventions. Interventions are built on diverse concepts or mechanisms, clustered in: ‘changing thoughts and behaviour’, ‘understanding the illness’ and ‘feeling supported’. Interventions described in this review are similar to those outlined in previous reviews that focus on, for example, psychotic disorders, and could decrease informal caregiver's burden and strain. Considering that only 13 relevant articles were identified from our search, we emphasise the need for further scientific attention to explore interventions that support the informal caregivers of people with depression, anxiety or personality disorders. Future researchers should explore how various intervention components and contextual factors affect outcomes, meet caregiver's diverse needs, and support practical implementation.</p>","PeriodicalId":14007,"journal":{"name":"International Journal of Mental Health Nursing","volume":"35 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12895140/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146168531","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":"Methodological Considerations in Modelling Stress and Well-Being Among Nursing Students: A Commentary","authors":"Wang Mei,&nbsp;Shi Hui,&nbsp;Wang Jinhuan,&nbsp;Wang Jiachun","doi":"10.1111/inm.70235","DOIUrl":"10.1111/inm.70235","url":null,"abstract":"","PeriodicalId":14007,"journal":{"name":"International Journal of Mental Health Nursing","volume":"35 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146151541","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}