International journal of mental health nursing最新文献

{"title":"The Meanings and Experiences of Motherhood in Women Diagnosed With Severe Mental Illness: A Tidal Model-Informed Qualitative Study.","authors":"Maria Romeu-Labayen, Glòria Tort-Nasarre, Olga Monistrol, Paola Galbany-Estragués","doi":"10.1111/inm.70322","DOIUrl":"10.1111/inm.70322","url":null,"abstract":"<p><p>Motherhood is a meaningful part of the life plans of many women diagnosed with severe mental illness, but they often experience motherhood or the desire for it in a context of vulnerability, stigma, and poorly coordinated care. The literature on the meaning of motherhood in this group is limited, especially research offering the perspective of humanistic models centred on the person. Identify how women diagnosed with severe mental illness give meaning to their desire to be mothers (or not) and their experience of motherhood (or not becoming a mother), using the Tidal Model as an interpretive framework. Descriptive qualitative study with intentional sampling. Eight women diagnosed with severe mental illness in Catalonia, Spain participated in semi-structured interviews. Data were analysed using thematic analysis guided by the Tidal Model. We report the findings using the COREQ criteria for qualitative rigour. We identified six themes structured in the three dimensions of the Tidal Model: (1) sharing the desire (or not) to become a mother; (2) stigma related to the decision to become a mother (or not to become one); (3) taking care of myself to become a mother; (4) self-stigma; (5) lack of specialised support and misinformation; and (6) barriers created by stigma. The narratives reveal the importance of validation, the impact of internal and external stigma, and the difficulties arising from the lack of service coordination. Participants faced multiple personal, relational, and structural barriers to their plans to become mothers. The findings indicate the need for interdisciplinary, empathetic, and person-centred care, as well as coordinated care circuits that integrate reproductive desire into clinical practice in mental health. Mental health nurses can play a pivotal role in validating women's reproductive desires, mitigating internal and external stigma, and providing nuanced, person-centred guidance regarding risks, care needs, and reproductive options. They are also essential in fostering coordinated care pathways that support informed decision-making and accompany women throughout their reproductive journeys.</p>","PeriodicalId":94051,"journal":{"name":"International journal of mental health nursing","volume":"35 4","pages":"e70322"},"PeriodicalIF":3.3,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13463105/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148714945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From Control to Connection: Reflections on Implementing Safe Steps in Acute Mental Health Units.","authors":"Alison Taylor, Matthew Flowers, Marie Hutchinson","doi":"10.1111/inm.70335","DOIUrl":"10.1111/inm.70335","url":null,"abstract":"<p><p>This paper presents a reflective account of the implementation of the Safe Steps for De-escalation practice model over a 12-month period across three acute mental health units. It describes the implementation process of the model, designed to reduce restrictive practices in acute mental health settings. The Safe Steps model is a mental health nurse-designed and led approach for person-centred, structured and relational de-escalation. It positions therapeutic engagement, emotional attunement, and psychological safety as central components of effective responding, particularly during high-stress situations. The model offers a practical and adaptable resource for diverse acute care environments. This paper examines the implementation process and lessons learned from a multi-site evaluation of the Safe Steps model in a number of acute mental health units. The evaluation was guided by the complexity model of Skivington et al. (2021), which emphasises multifaceted real-world approaches to evaluation. Drawing on reflective accounts from the research and implementation leads, using practice-informed insights, the paper explores the opportunities, challenges and lessons learned in embedding a relational de-escalation model into everyday clinical practice. Particular attention is given to capability building, scenario-based learning, and team-based support strategies that facilitated implementation. The findings highlight the importance of leadership, emotional safety, and inclusion of the consumer voice in sustaining reductions in coercive practices. The paper offers practical insights for clinicians and researchers seeking to implement relational and trauma-informed approaches in acute mental health services.</p>","PeriodicalId":94051,"journal":{"name":"International journal of mental health nursing","volume":"35 4","pages":"e70335"},"PeriodicalIF":3.3,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13479031/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148765549","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"'Hard-to-Reach' or 'Hardly Reached'? Underservice, Marginalisation and Inequity in Care.","authors":"Debra Jackson, Carmel Bond, Adrianna Watson, Michelle Cleary","doi":"10.1111/inm.70286","DOIUrl":"10.1111/inm.70286","url":null,"abstract":"<p><p>In mental health care, the term 'hard-to-reach' is frequently used in relation to individuals and populations who have reduced access and engagement with services. While positioned as a neutral term, this term can conceal and minimise the multiple factors influencing access to and engagement with care. It also clearly places the responsibility for disengagement as an individual decision or failing, removing responsibility from services themselves. In this paper, we consider the term 'hard-to-reach' and provide a counter-framing of 'hardly reached' to centre patterns of underservice within mental health services and systems. Using the phenomenon of being unhoused as a lens, we consider how language informs assumptions about people and populations. We propose that the label 'hard-to-reach' operates discursively to redirect attention from service limitations and reinforce deficit-based positioning of marginalised people and populations. Contrary to this framing, the concept of 'hardly reached' refocuses attention back to the ways in which service design contributes to disengagement with care services. We highlight the obligations of mental health services and systems to recognise and effectively address structural barriers. We argue that embracing a 'hardly reached' position provides us with a more ethically responsive and socially just framework for understanding and addressing systemic inequities in mental health care.</p>","PeriodicalId":94051,"journal":{"name":"International journal of mental health nursing","volume":"35 3","pages":"e70286"},"PeriodicalIF":3.3,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13284725/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148298109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Therapeutic Use of Self by Mental Health Nurses: An Evolving Practice.","authors":"Catherine Hungerford, Denise Blanchard, Andrea McCloughen","doi":"10.1111/inm.70263","DOIUrl":"10.1111/inm.70263","url":null,"abstract":"<p><p>The therapeutic use of self, first articulated by Peplau in the 1950s, remains fundamental to mental health nursing practice, yet continues to be interpreted in diverse ways. This paper reports findings of a qualitative descriptive study, situated within a constructivist paradigm, exploring how experienced Australian mental health nurses understand and apply the therapeutic use of self in contemporary recovery-oriented contexts. Eleven mental health nurses participated in semi-structured interviews, with data analysed using reflexive thematic analysis. Three interrelated themes were developed: 'Diverse conceptualisations of the therapeutic use of self'; 'The prominence of self-disclosure'; and 'The nurse as a therapeutic instrument'. Participants described the therapeutic use of self as an intentional and reflective use of the professional self to foster connection, presence and trust. While the value of self-awareness and relational authenticity was acknowledged, self-disclosure emerged as a significant, ethically bounded strategy within a broader reflective orientation. By recognising the diverse conceptualisations of the therapeutic use of self, this study offers a more integrative formulation of the practice as relational, contextual and also experiential, with the prominence of self-disclosure reflecting evolving socio-cultural and recovery-oriented frameworks. Such recognition strengthens shared professional language, education and critical reflection in mental health nursing practice.</p>","PeriodicalId":94051,"journal":{"name":"International journal of mental health nursing","volume":"35 3","pages":"e70263"},"PeriodicalIF":3.3,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13121870/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147793118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recovery-Oriented Conversations in Psychiatric Care: An Integrated Systematic Review.","authors":"Promise Ezinne Ekezie, Alexander Rozental, Git-Marie Ejneborn-Looi, Ursula Werneke, Sebastian Gabrielsson","doi":"10.1111/inm.70295","DOIUrl":"10.1111/inm.70295","url":null,"abstract":"<p><p>In psychiatric settings, recovery-oriented care follows a relational, person-centred approach. In mental health nursing, such care extends beyond merely reducing symptoms to foregrounding hope, identity, meaningfulness, empowerment, and personal agency. Because an important aspect of putting that approach into practice is engaging in conversations that promote recovery, understanding the concept of recovery-oriented conversations (ROCs) is essential. In this review, we aim to synthesise existing research on ROCs and offer insights into their implementation, challenges, and impact on patients' recovery. An integrative review of studies (i.e., qualitative, quantitative, and mixed-methods) published between 2015 and 2025 in PubMed, CINAHL, PsycINFO, Scopus, and Web of Science returned 5298 studies, 49 of which we included in a narrative synthesis using deductive coding from an inductive perspective. The findings suggest that ROCs are conceived as being well-structured, context-sensitive conversations that create space for expression and the co-creation of recovery-oriented pathways while probing personal and social realities. ROCs are effective when grounded in deep engagement, shared goal-setting, and supportive environments. The practice, reflecting the connectedness, hope, identity, motivation and empowerment (CHIME) framework, is perceived as nurturing safety, promoting relational depth, and reaffirming personhood. Whereas barriers to implementation include limited time, staffing constraints, hierarchical cultures, and inconsistent leadership, facilitators include clear communication, culturally responsive practices, and organisational support. Altogether, ROCs allow mental health nurses to deliver care, strengthen therapeutic relationships, and foster shared decision-making. Embedding them into successful practice, however, calls for more research, training, cultural sensitivity, and systemic alignment.</p>","PeriodicalId":94051,"journal":{"name":"International journal of mental health nursing","volume":"35 3","pages":"e70295"},"PeriodicalIF":3.3,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13284807/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148298157","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Violence Management in Mental Health Nursing: A Conceptual Analysis.","authors":"Kenji Takahashi, Koji Tanaka, Kyoko Nagata","doi":"10.1111/inm.70289","DOIUrl":"10.1111/inm.70289","url":null,"abstract":"<p><p>Violence in mental illness settings poses a serious problem, threatening nurses' physical and psychological safety and compromising quality of care. Front line responses tend to rely heavily on nurses' individual capabilities, making the establishment of organisational support systems and management policies an urgent necessity. This study aimed to clarify the essence and components of the concept 'violence management' in mental health nursing and to propose a definition that will contribute to future practice and education. We analysed 35 articles, following Rodgers' (2000) conceptual analysis methodology and reporting in accordance with PRISMA guidelines. Four antecedent conditions were identified: 'consumers' ineffective impulse control', 'nurses' affinity for exposure to violence', 'difficulty in establishing a shared understanding of safety', and 'lack of consistency in violence response'. In addition, five attributes were identified: 'relationship-centred non-invasive care', 'ensuring a safe healthcare environment', 'adherence to forensic frameworks', 'early risk detection', and 'professional capacity development'. Five consequences were also identified: 'strengthening support for nurses', 'strengthening human resource development', 'organisational conditions that strengthen safety', 'challenges in violence reporting', and 'challenges in assessment tools'. Mental health nursing defines the concept of violence management as an effort to provide flexible and comprehensive care across national and cultural differences in response to diverse and uncertain factors that make consumer impulse control difficult, maximising limited resources while establishing an organisational support system. This definition presents a new framework linking nursing management and clinical practice.</p>","PeriodicalId":94051,"journal":{"name":"International journal of mental health nursing","volume":"35 3","pages":"e70289"},"PeriodicalIF":3.3,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13276436/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148274119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Methodological Concerns About Synthesising Intervention Effects in a Scoping Review of Nursing Interventions for Anxiety and Sleep.","authors":"Li Nannan, Cao Xiaofei, Wang Yilin, Linlin Zhang","doi":"10.1111/inm.70288","DOIUrl":"https://doi.org/10.1111/inm.70288","url":null,"abstract":"","PeriodicalId":94051,"journal":{"name":"International journal of mental health nursing","volume":"35 3","pages":"e70288"},"PeriodicalIF":3.3,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148267590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From Care to Coercion: Service User and Carer Experiences of Police-Involved Mental Health Crisis Responses.","authors":"Emilie Hudson, Clara Lessard-Deschênes, Audrey-Anne Dumais Michaud, Marie-Hélène Goulet","doi":"10.1111/inm.70273","DOIUrl":"10.1111/inm.70273","url":null,"abstract":"<p><p>Police and specialised police teams are frequently called to respond to mental health crises, often becoming de facto gatekeepers to care. Yet the perspectives of people in crisis and their carers remain underrepresented in the literature. The aim of this review is to explore the lived experiences of people, including carers, who encounter police or specialised police teams during a mental health crisis. A narrative review was conducted following Sukhera's five-step approach. Searches across CINAHL, MEDLINE, PsycInfo, and Sociological Abstracts identified 33 qualitative studies from eight countries. Data were analysed thematically. Results reveal nuanced experiences, ranging from trust in police and crisis services to refusals to ever call them again; from successful de-escalation to rapid escalation; and from encounters that preserved life to those that ended it. Five themes were identified: (1) Initiating and navigating the crisis response; (2) Interacting and communicating during the response; (3) Perceptions of safety, risk, and coercion during the response; (4) The harms of the response; and (5) Improving police and specialised police team response. The review clearly lists the types of coercion that can be experienced during these responses, whether they involve only police officers or a co-responder model. The findings highlight that positive crisis response experiences depend on whether interactions are perceived as fair, respectful, humane, and non-coercive. While some encounters are supportive and lifesaving, negative experiences often carry disproportionate weight, eroding trust and deterring future help-seeking. More approaches grounded in procedural justice theory are needed to reduce coercion and rebuild trust.</p>","PeriodicalId":94051,"journal":{"name":"International journal of mental health nursing","volume":"35 3","pages":"e70273"},"PeriodicalIF":3.3,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148019741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Culturally Adapted Cognitive Behavioural Therapy and First Nations Population: A Role for Nurses?","authors":"Robert Batterbee, Aunty Kerrie Doyle, Katherine Te Arii, Catherine Hungerford","doi":"10.1111/inm.70290","DOIUrl":"10.1111/inm.70290","url":null,"abstract":"<p><p>This perspective paper examines the inconsistent integration of cognitive behavioural therapy (CBT) into the mental health care of First Nations people and considers the implications for mental health nursing practice. Although CBT is widely endorsed as an evidence-based treatment for depression, anxiety, post-traumatic stress disorder and chronic health conditions, its application in First Nations contexts remains uneven, with limited evidence of nurses delivering the intervention. Drawing on national and international literature, the paper explores whether this inconsistency reflects cultural misalignment, structural barriers or workforce limitations, and considers the role of nurses, who are well placed to address these challenges within communities. The discussion highlights tensions between the individualised, cognition-focused assumptions underpinning CBT and Indigenous worldviews grounded in relational, community-oriented and holistic conceptions of social and emotional wellbeing. Without meaningful cultural adaptation and partnership, standardised CBT risks reinforcing mistrust shaped by colonisation, systemic racism and historical trauma. Conversely, its relative absence may restrict access to evidence-based care. Systemic factors are examined, including limited culturally responsive training and the under-recognised role of nurses in delivering structured therapies. Evidence indicates nurse-led CBT is feasible and effective, positioning nurses as a bridge between Western interventions and culturally safe practice. The paper concludes that meaningful progress requires more than surface adaptation and calls for First Nations nursing leadership in co-designing culturally grounded CBT implementation.</p>","PeriodicalId":94051,"journal":{"name":"International journal of mental health nursing","volume":"35 3","pages":"e70290"},"PeriodicalIF":3.3,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13274476/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148267532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Protected Engagement Time and Related Interventions: A Scoping Review of Experience and Outcomes, and Relevance to the Australian Context.","authors":"Donna Hristodoulidis, Brent Hayward, Adam Searby","doi":"10.1111/inm.70267","DOIUrl":"10.1111/inm.70267","url":null,"abstract":"<p><p>Engagement between mental health nurses (MHNs) and older adults on acute mental health units is often hindered by age-related factors such as cognitive decline, frailty and sensory impairment, as well as psychosocial challenges including bereavement, social isolation and loss of identity. This makes therapeutic engagement essential on older adult mental health units. However, high workloads, administrative demands and the dominance of risk management often limit meaningful interactions. Protected engagement time (PET), originally introduced in the United Kingdom, was designed to preserve dedicated, interruption-free time for MHNs to engage therapeutically with consumers. This scoping review aimed to map existing literature on PET and to examine its relevance to the Australian older adult acute mental health context. The review was conducted in accordance with the Joanna Briggs Institute methodology and reported using the PRISMA-ScR checklist. After screening, eight studies met the inclusion criteria, with none conducted in Australia, and only two focused specifically on older adult units. Data analysis revealed four overarching categories: relational engagement and therapeutic presence, individualised and meaningful engagement, staffing and organisational structure, and outcomes and broader impacts. This scoping review suggests that PET can positively influence engagement between mental health consumers and MHNs, with benefits extending beyond the sessions themselves. However, the review highlights the need to evaluate how this approach may be integrated in older adult mental health units to enhance the therapeutic relationships, promote recovery and uphold dignity to some of the most vulnerable consumers in mental health care.</p>","PeriodicalId":94051,"journal":{"name":"International journal of mental health nursing","volume":"35 3","pages":"e70267"},"PeriodicalIF":3.3,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13179429/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147950475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}