Despite a global drive to improve staff well-being in healthcare, distress and absenteeism continue to persist, posing consequences for patient care and organisational functioning. Current research and subsequent strategies implemented to remediate such problems have primarily focused on occupational experiences, disregarding the contribution of problems occurring outside of the workplace. The current study sought to establish the prevalence of work and non-work problems, and their respective impacts on several well-being outcomes, in this occupational group. Secondary analysis of data from a cross-sectional survey of 323 staff in a secure UK mental healthcare organisation was conducted. Exposure to non-work problems was pervasive across the sample (79.3%). Demographic discrepancies in exposure to types of problems were apparent, though number of problems reported was comparable across the sample. Number of non-work problems was a significant predictor of depression, anxiety, functional impairment, and complex post-traumatic stress disorder symptoms, when controlling for exposure to work problems. The findings implicate the need for a broader conceptualisation of distress in secure mental healthcare staff, who typically report exposure to several non-work problems, in the context of occupational challenges. Policy, practice and service implications are discussed, with consideration for the availability and modality of support offered to staff.

The purpose of this integrative review is to describe latent or covert signals of cyber victimization and risky online behaviors in teens. This review was guided by Whittemore and Knafl's integrative review method. A literature search of peer-reviewed, primary source studies published between January 2010 and February 2022 was conducted using the following databases: Cumulative Index of Nursing and Allied Health Literature Plus with Full Text (CINAHL), APA Social Work Abstracts, ERIC, PsycInfo, and APA PsycArticles. Initially, the search string was (cyber victimization OR cyberbullying) AND (risky) AND (internet OR online) AND (signs OR symptoms) AND (latent OR covert OR hidden OR cryptic) AND (lived experience OR perceived OR perception). Additional terms were added, including social engineering. A total of 20 articles were included in this review. Four themes emerged from the literature: (1) the reciprocal nature of cyber victimization and risky online behaviors, (2) latent or covert signs and symptoms, (3) new language surrounding teens' online experiences, and (4) barriers to disclosing experiences. Latent or covert signs and symptoms were categorized into two sub-themes: (1) mood dysregulation and (2) online interaction and expression. Barriers to disclosing experiences were categorized into two subthemes: (1) reluctance to disclose and (2) minimization or disconnection of experience. Qualitative studies yielded richer information concerning the experiences of teens who experienced cyber victimization. Future research using qualitative methodologies and direct analysis of public social media posts are needed to effectively detect the latent or covert signs and symptoms of cyber victimization and risky online behaviors.

Violence against healthcare workers continues to be a widespread problem and adversely impacts both healthcare providers and consumers.

: The review explores current evidence on Australian pre-registration nurse education in preparing graduates to work in mental health settings, from the perspectives of the graduates. : A scoping review using the Joanna Briggs Institute framework for scoping reviews and the Preferred Reporting Items for Systematic and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) checklist was undertaken. : There were 31 eligible publications, reporting 12 qualitative studies, eight surveys and 11 quasi-experimental studies. All were in English language peer reviewed journals, published between 2000 and July 2023. Five themes emerged: 1. Well-organised and supported clinical placements can reduce stigma; 2. Student concerns regarding mental health clinical placements can be lessened when placements are well-designed; 3. Well-organised and resourced clinical placements can increase interest in mental health nursing; 4. Simulation learning can increase confidence during clinical placements; 5. Teaching by Experts By Experience (EBE) can reduce stigma and improved student attitudes. : Evidence from 31 eligible publications indicated that properly resourced, purpose-designed theoretical and clinical learning experiences can be effective in reducing stigmatising attitudes and behaviours in pre-registration nursing students. Involving EBEs in mental health teaching is an important, but so far under-utilised, development in pre-registration nursing programmes in Australia.

To determine the acceptability of targeted apps and provide recommendations for the implementation of and app addressing high risk alcohol use to nurses.

Transitioning from child to adult services is a significant event for young adults. The study aimed to explore the experiences of young adults who transitioned from Child and Adolescent Mental Health Services (CAMHS) to Adult Mental Health Services (AMHS) in Ireland. Semi-structured interviews were conducted with six young adults and analysed according to interpretative phenomenological analysis. Interpretations were subsequently viewed through the lens of transition theory. Findings indicate that the transition presents major challenges for young adults and can cause a deterioration in mental health, in the context of multiple concurrent life transitions, discontinuity of care, a dramatic culture shift in AMHS, and experiences of impersonal care. Participants expressed their view that AMHS clinicians did not know how to approach their treatment due to a lack of available options or diagnosis-specific expertise, leading these individuals to question the validity of their suffering; this is a novel finding in the context of previous transition research. The utility of transition theory in developing a CAMHS-AMHS transition framework is demonstrated.

As primary care (PC) clinics seek to integrate behavioral health (BH) services into patient care, it is crucial to understand the experiences of the clinic team and the impact on workflow and well-being. This study was designed to identify perspectives and experiences of nurse practitioner-led PC teams as they implemented a behavioral health integration (BHI) model into their Federally Qualified Health Center PC practices.

First-episode psychosis is a significant mental health condition that can have a profound and lasting effect on an individual's functional abilities and overall quality of life. While music therapy has shown promise in improving these areas, there is a lack of research exploring the impact of music groups led by mental health professionals without formal music therapy training in the context of early intervention in psychosis. This study aimed to conduct a qualitative evaluation of a once-weekly, 12-week, nurse-led music group, offered as an adjunct to early intervention in young people with first-episode psychosis. The specific objectives were to explore social interaction and experiences of participants and instructors in relation to the music group and provide focus points for implementation in clinical practice. The study utilized Interpretive Description, collecting data through participant observation (6 sessions × 1.5 hrs; 9 hrs in total), key informant interviews ( = 1), and group ( = 4) and email-based ( = 2) interviews. The data was transcribed, thematized, and analyzed using NVivo12 and Interpretive Description inductive analysis resulting in three main themes: Practicalities of the music group, Restored identity, and Music as medicine reflecting the potential of the music group to contribute to a sense of non-patient identity, decreasing symptoms related to mental illness, foster social relationships and a feeling of belonging to a musical community. This study highligts how participation in music groups can be a possible promoter of recovery. However, sustainability appears contingent on the skills and resources of the facilitator (i.e., nurse). Suggestions for a program theory and clinical implications are presented and discussed.

The goal of this study was to examine the influence of the COVID-19 pandemic, including public health measures (mitigation and containment efforts), on new onset mental health diagnoses by age group. This study was a longitudinal retrospective cohort study. Data on new mental health diagnoses were extracted from the University of California Health System Electronic Health Records (EHR) that contained five academic health centers in California. Data were examined for identical timeframes before the COVID-19 pandemic (historical control cohort) and following the start of the pandemic (case cohort). Paired t-tests were used to test for differences in the number of new mental health diagnoses by age group. A two-way ANOVA was used to test for between group differences. The largest increase in mental health diagnoses (overall) was observed in the 26-35-year-old age group ( < 0.001) and for the following mental health diagnoses: anxiety, bipolar, depression, mood disturbance, and psychosis. Study findings may inform post-pandemic recovery efforts and pandemic preparedness strategies for future public health emergencies. Specifically, findings may guide the deployment of mental health screening, universal mental health interventions, and resource allocation for mental health to best support at risk groups during times of high vulnerability.

The social movements of #metoo and #notokay illuminated the extent of sexual violence. By providing a safe platform the movement enabled victims/survivors opportunity to share their own experiences of victimization, often in a delayed disclosure, years after the violence occurred. With new disclosures of sexual violence, also comes a growing awareness of the lasting impact and the requirement to take steps to improve responses to sexual violence across the social and clinical spectrum to address and respond to victims/survivors' holistic needs. The primary research question is, what is the retrospective life experience of individuals marginalized by gender who encounter sexual violence in post-secondary education? The authors of this manuscript used trauma- informed qualitative individual interviews with a feminist perspective to explore the retrospective experience of 10 victim/survivors, a decade or more after their experience of sexual violence. The inquiry discovered the themes of recognizing the wrong, the internal struggle, forging new relationships, and the lasting trauma of sexual violence. Learning from those that lived it legitimizes victims/survivors' experiences and deepens clinical knowledge of these impacts and associated needs.

Mental health professionals are at a heightened risk of secondary traumatic stress (STS) due to the higher prevalence of trauma-exposed individuals seeking clinical help compared to the general population. The aims of this study were as follows: (1) to explore the association between exposure to workplace violence (WPV) and secondary traumatic stress, and the potential mitigating effects of organizational support and (2) to examine how the workplace setting (inpatient vs outpatient) affects the experience of STS. The study was cross-sectional. Over 58 days, survey data was collected from mental health professionals working in both inpatient and outpatient settings. A total of 2,549 professionals responded. The overall prevalence of STS across settings was 87%. The highest reported secondary traumatic stress levels were among nurse practitioners/APRNs (49.29%), followed by nurses (47.94%) and psychiatrists (46.85%). Levels of STS occurred at slightly higher levels among professionals in outpatient settings (48.39%) than those in inpatient settings (45.11%). Increased exposure to WPV correlated with higher levels of STS, while higher levels of perceived organizational support (POS) had a moderating effect on STS levels. This study suggests that STS is a significant phenomenon and that mental health professionals are at risk for developing the condition. Organizational support can play a role in mitigating the effects of WPV and STS. Interventions aimed at improving organizational support and building psychological resilience may help reduce the prevalence of STS among this population.

The aim of this review was to identify and integrate evidence on suicide mortality among U.S. nurses. To the best of our knowledge, this represents the first review to focus exclusively on suicide among U.S. nurses. Electronic medical databases, reference lists, and supplementary files were searched to identify studies that examined suicide mortality among U.S. nurses. In total, n = 28 studies were included: n = 14 were cohort, n = 10 were epidemiological, and n = 4 utilized mixed methods. Many studies had unique aims, included different nurse groups and referent populations, and utilized a variety of statistical procedures. However, when taken together, four categories were assessed across these n = 28 cumulative studies: incidence of suicide, factors associated with suicide, circumstances preceding suicide, and methods of suicide among U.S. nurses. Taken together, continued surveillance of suicide incidence among U.S. nurses is important, as evidence largely suggests nurses experience elevated suicide incidence when compared to select referent groups. Additional research on factors associated with suicide and circumstances preceding suicide are also needed, particularly among male nurses. Finally, additional research regarding the leading method of suicide, leading substance implicated in self-poisoning, and sex-differentiated suicide methods are also important. Collectively, these data are needed to inform intervention and surveillance strategies.

Risk assessment and safety planning are central to mental health nursing practice but were seriously affected by the Covid-19 pandemic and associated lockdowns. In this study, we aimed to explore how the UK pandemic lockdowns affected risk assessment and safety planning from the perspective of mental health practitioners. A sequential, mixed methods study design was used. A link to an online survey questionnaire was distributed and semi-structured interviews with a subset of respondents were conducted. Survey data were analysed to describe perceived changes in the frequency and nature of risk assessment and safety planning during the pandemic lockdowns. This was supplemented by thematic analysis of qualitative interview data. In total, 106 practitioners were surveyed and 10 participated in semi-structured interviews. More respondents increased than decreased risk assessment frequency but there was no significant overall change. Remote contact was more common in community settings and largely involved telephone appointments. Participants did not wish to continue with remote working following the pandemic. Risk assessment practice changed in UK mental health services as a result of COVID-19 lockdowns.

The lives of houseless individuals are characterized by powerlessness, meaninglessness, hopelessness, and despair, yet they have a desire to escape homelessness. While the economic aspect is essential for escaping homelessness, psychological resources are crucial, as they form the basis of the strength needed to achieve independence. The study aimed to examine the effectiveness of a logotherapy-based empowerment program developed to strengthen the capabilities of persons living houseless and ultimately develop competencies that serve as a foundation for self-reliance. The study was performed in a homeless support center for men living houseless in South Korea using a repeated-measures design with a control group. The experimental group received an eight-session empowerment program over 8 weeks. The participants were assessed at three intervals: pretest, posttest immediately after the program, and follow-up test 4 weeks after the posttest. The follow-up tests were completed by 22 and 16 participants in the experimental and control groups, respectively. We found that the empowerment program significantly enhanced the meaning of life, hope, and empowerment of houseless individuals. Community mental health nurses, who are in a position to interact with persons living houseless, must empower them to escape homelessness and achieve self-reliance, an important goal for this population.

Digital media which involve narrative storytelling are increasingly used in nursing and health research, including clinical applications such as cinematherapy. A pilot study was conducted on how digital media self-accessed by marginalized individuals may be beneficial toward mindfulness and healing from trauma. Qualitative interviews were conducted with individuals ( = 8) who self-reported marginalizations via: race; gender; rural geography; socioeconomic status; indigenous or colonial experience; survivor of abuse; experiences of homelessness; or disability. Results indicated that trauma-narratives often organically emerge through discussions on digital media, with notable intersections with mindfulness-based practices and interventions. First, digital media can create a mindfulness of trauma as valid to discuss and disseminate. Mindfulness of authentic resolution also emerged as critical, as trauma may be employed in media narratives for attention or sympathy with no intent to support healing. Participant responses illustrate value in being mindful of individuals with severe trauma, who may be less likely to benefit from digital media. Digital media can foster sense-of-belonging and community-building amidst isolation; additionally, parasocial relationships may help foster supportive identities and ideologies on vulnerability. Findings are outlined in a preliminary conceptual framework, toward supporting future digital media with intent to create mindfulness or heal trauma.

Police officers are increasingly tasked with responding to people in crisis (PIC), often resulting in transfers to emergency departments (EDs) where they can encounter challenges like long wait times, safety concerns, and conflicting perspectives between the medical and legal systems. This qualitative study explores the experiences of police officers during the transfer of PIC to ED nurses and staff. Eleven police officers were recruited and interviewed, providing contextual information about ED transfers in the greater Montreal area. The findings revealed that police officers face varied challenges in transferring PIC to different EDs, influenced by each hospital's unique characteristics, staffing, security, and organizational issues. Relationships with nurses significantly impact these experiences, ranging from positive interactions to tension and conflict influenced by staff biases and differing perceptions of the PIC. Effective communication between police and ED nurses is critical for accurate clinical evaluation and decision-making, yet often hindered by inconsistent information transfer and procedural gaps. Role confusion, divergent philosophies between police officers and ED nurses, and 'grey zones' further complicate transfers, emphasizing the need for clear communication and mutual understanding to ensure safe and effective care. The results underscore the need to ameliorate ED transfers through enhanced joint training for police officers and nurses, establishing hospital-precinct committees, and other intersectoral initiatives to promote collaboration. Such measures are essential to ensure effective and compassionate care of people in crisis while prioritizing safety for all involved.

This study aims to provide a new perspective on the concept of recovery by qualitatively analyzing the experiences of mentally ill people from the Japanese perspective through autoethnography. Traditionally, the recovery process has been viewed as a series of "ups and downs" that may not apply to individuals with chronic mental health issues. A qualitative autoethnography analysis used personal diary entries from 20XX through 20XX + 4. Using text mining with KH Coder and cluster analysis, I first classified and visualized the data from the diary content and then, after confirming the content chronologically, examined the validity of the concept of the recovery process based on the theoretical framework of the Japanese cultural perspective. External validity was ensured through triangulation with the author's work. Coding revealed four to six groups of mental health recovery keywords for each year. Confirmation of the results according to the life history also revealed problems with the conventional recovery process concept and advantages of the flat recovery process based on the Japanese cultural perspective.

The aim of this study was to validate the diagnostic content and the NANDA-I and NOC linkages for six psychosocial nursing diagnoses. This multicentre, descriptive, cross-sectional validation study followed Fehring's model. Expert nurses in nursing methodology and standardised nursing languages in Spain participated, with expertise criteria based on academic level and clinical, teaching, and research experience in the fields of nursing methodology and standardised nursing languages. This study adhered to the STROBE guidelines for cross-sectional studies. Eighty-seven professionals participated in the diagnostic content validation phase, and 57 in the NANDA-I and NOC linkages validation phase. The content validity indices of the six diagnoses ranged from 0.74 to 0.84, all considered valid. All 84 proposed defining characteristics were valid, with 42 scoring ≥0.8. Thirty-two linkages between diagnoses and NOC outcomes were proposed, all valid, with mean scores between 0.73 and 0.98. Each diagnosis was linked to 5-6 NOC outcomes, comprising 26 main outcomes and 6 supplementary outcomes. Overall coverage rates for each diagnosis ranged from 68.42% to 100%. All linkages between defining characteristics and NOC outcome indicators were validated. The six selected psychosocial diagnoses, their defining characteristics, and the proposed linkages between diagnoses and outcomes have been validated. The validation of linkages between NOC indicators and nearly all major defining characteristics of these six psychosocial diagnoses will make it possible to enhance diagnostic accuracy and enable continuous assessment of the effects of nursing interventions on the clinical progression of these diagnoses.

Non-adherence to antipsychotic medications is a commonly recognized problem that can lead to lack of follow-up for patients with schizophrenia spectrum disorders, increasing risk for psychotic symptoms, hospitalizations, and decreased quality of life. We conducted a secondary data analysis of electronic health record data of patients with schizophrenia spectrum disorders ( = 1,341) in Central Florida to explore relationships between geographic access to mental healthcare facilities, socioeconomic factors, and follow-up visits, and whether these conditions contributed to adherence over 1 years' time. Using Geographic Information Systems among six mental health facilities, spatial analysis and logistic regression indicated that patients had 27.9% increased odds ( = 0.02) of adherence to treatment when travel time to facilities was 30 min or less. Spatial autocorrelation revealed significant positive clusters in areas with low travel time (15 min or less). Patients who had Medicaid, a case manager and/or a life skills coach, medication side effects, a substance use disorders history, and/or closer proximity to mental healthcare services, had an increased likelihood of attending four or more follow-up visits in 1 year. Identifying effects of spatial and non-spatial variables on non-adherence to treatment can provide useful insights for developing targeted interventions to improve treatment outcomes.

Intimate partner violence (IPV) against women is widely recognized as a significant global problem, a major public health issue in the United States, and one of the most widespread violations of human rights. Recent research has noted that non-fatal strangulation (NFS) has been a significantly overlooked indicator and by-product for victims of IPV and often may be undisclosed or can be confounded with other mental health symptoms; for example, those that are common with conditions seen in psychiatric facilities. Traumatic brain injury (TBI) and nonfatal strangulation are often unrecognized forms of IPV and can lead to significant short and long-term neurologic sequelae. It is possible that some mental health disturbances and anxiety symptoms may be better explained as a medical consequence of TBI and repeated NFS-or a signal of homeostatic disruption. In such cases, providing psychopharmacological treatment might help the patient with the symptoms, but will not address the underlying cause. This reinforces the critical need for mental health nurses to not only assess for IPV, but simultaneously screen for TBI-related neurological disorders and injuries, including recent and/or past unconsciousness, and facilitate linkage to IPV interventions and mental health treatment.

Panic attacks (PAs) are intense episodes of anxiety with severe physical symptoms that can impair an individual's social and occupational functions. Psychoeducation, a structured educational intervention, aims to improve various health aspects, including mental disorders. Delivering psychoeducation via the Internet can overcome barriers to accessing mental health treatment. This study examined the effectiveness of online psychoeducation on panic symptoms, anxiety, and quality of life (QOL) among people experiencing PAs. In this quasi-experimental design, 157 participants with PAs were recruited, and 136 eligible participants were allocated to treatment and control groups. The treatment group received an eight-session online psychoeducational program over 8 weeks, while the control group received reading materials. Outcome variables, including panic symptoms, anxiety, and QOL, were measured at baseline, 1-week post-intervention, and at 8-week follow-up using the Panic Disorder Dimensional (PD-D) scale, the Generalized Anxiety Disorder (GAD-7) scale, and the World Health Organization Quality of Life-BREF (WHOQOL-BREF), respectively. In the treatment group, the split-plot ANOVA showed a significant reduction in panic symptoms [F(1, 98) = 18.86,  < 0.01] and anxiety [F(1, 98) = 18.241,  < 0.01] compared to the control group. However, the intervention did not significantly affect QOL [F(1, 98) = 0.278, MSE = 153.007,  > 0.05]. The online psychoeducational program effectively reduced panic symptoms and anxiety levels but did not significantly impact QOL. Internet-based interventions, including psychoeducation, can improve access to mental health treatment, potentially reducing the treatment gap and enhancing overall mental health outcomes.

In Sweden, approximately 1,200 individuals die by suicide annually. Inpatient suicide is considered rare, but death by suicide still occurs when admitted to a psychiatric hospital. This study was part of a national retrospective project covering data from all patients' medical records for the 2 years before death by suicide in 2015. In this study, 41 patients who died by suicide while being admitted to psychiatric care were identified. The aim was to retrospectively identify documentation of suicide risk, safety measures, and comparisons between those with and without suicide attempts for patients who died by suicide during psychiatric inpatient care. There was documentation of suicidal variables in 80% of the patients; 59% had a previous known suicide attempt, 63% were diagnosed with mood disorders, and 41% were assessed for elevated suicide risk. The most common suicide method was hanging, suffocation (68%), and 22% had died by suicide within 24 h after admission. Almost three-quarters were on voluntary care. No patients had constant professional supervision on a one-to-one basis, and 17% had 15-minute checks. One-third were on agreed leave at the time of the suicide. These results emphasise the lifesaving role of high-level supervision in the early stages of inpatient care.