Stakeholder perspectives on co-designing a post-registration mental health nursing curriculum: A case study.

INTRODUCTION: Globally, healthcare regulatory bodies require providers of academic programs to involve service users in the design and delivery of education, yet concrete and tested directions for operationalising this are lacking. Service users' involvement in education is often passive, ad-hoc and tokenistic, with limited input at the program development level. AIM: To explore the co-design processes and outcomes of a collaborative revision of an Australian post-registration mental health nursing curriculum. METHOD: Using qualitative case study design, the experiences and collaborative practices of five stakeholders (one mental health service user, two carers and two academics) co-designing a post-registration mental health nursing curriculum were explored. RESULTS: Commonly identified barriers to meaningful involvement were overcome through planning and collaborative execution of the group's work. Participants reported a strong sense of successful collaboration in reviewing the curriculum, trusting relationships and mutual respect. DISCUSSION: While it was possible to support and augment stakeholder knowledge in the context of post-registration education, co-design processes were ultimately bound by the university's relatively inflexible bureaucratic context. IMPLICATIONS FOR PRACTICE: To ensure effective stakeholder collaboration beyond classroom teaching, mental health nurse academics must prepare service users for the role, explaining the language and practices of the tertiary health education and nursing context. As part of co-design processes, organisational mandates must be explored and negotiated, and mutual clarity regarding expectations and roles must be established. A Design Thinking approach can support meaningful engagement of stakeholders in curriculum development.

What do we know about the experience of seclusion in a forensic setting? An integrative literature review.

Seclusion is used in forensic and general mental health settings to protect a person or others from harm. However, seclusion can result in trauma-related harm and re-traumatization with little known about the experience of seclusion for consumers in forensic mental health settings from their perspectives. This article explores consumer experiences of seclusion in forensic mental health settings and explores the differences between female and male experiences of seclusion. Five electronic databases were systematically searched using keywords and variations of experience, attitude, seclusion, coercion, forensic mental health, and forensic psychiatry. Inclusion criteria were original peer-reviewed studies conducted in adult forensic mental health settings reporting data on the experiences of or attitudes towards seclusion. Seven studies met the criteria for inclusion and a quality assessment was undertaken. Results found consumers in forensic mental health settings perceive seclusion to be harmful, a punishment for their behaviour, and largely a negative experience that impacts their emotional health. Some consumers report positive experiences of seclusion. Differences in the experience of seclusion for females and males are unclear. Further research is required to understand the experience of seclusion for women in forensic mental health settings. Identification and consideration of differences in the experience of seclusion for males and females may assist in identifying sex-specific interventions and may inform policy and practices to eliminate or reduce the trauma associated with seclusion use.

What do we know about the experience of seclusion in a forensic setting? An integrative literature review.

Seclusion is used in forensic and general mental health settings to protect a person or others from harm. However, seclusion can result in trauma-related harm and re-traumatization with little known about the experience of seclusion for consumers in forensic mental health settings from their perspectives. This article explores consumer experiences of seclusion in forensic mental health settings and explores the differences between female and male experiences of seclusion. Five electronic databases were systematically searched using keywords and variations of experience, attitude, seclusion, coercion, forensic mental health, and forensic psychiatry. Inclusion criteria were original peer-reviewed studies conducted in adult forensic mental health settings reporting data on the experiences of or attitudes towards seclusion. Seven studies met the criteria for inclusion and a quality assessment was undertaken. Results found consumers in forensic mental health settings perceive seclusion to be harmful, a punishment for their behaviour, and largely a negative experience that impacts their emotional health. Some consumers report positive experiences of seclusion. Differences in the experience of seclusion for females and males are unclear. Further research is required to understand the experience of seclusion for women in forensic mental health settings. Identification and consideration of differences in the experience of seclusion for males and females may assist in identifying sex-specific interventions and may inform policy and practices to eliminate or reduce the trauma associated with seclusion use.

Compassion fatigue in mental health nurses: A systematic review.

WHAT IS KNOWN ON THE SUBJECT?: Compassion fatigue is the result of the unique stressors inherent in caregiving work, leading to a loss of compassion in clinical practice that may result in negative outcomes for mental healthcare consumers. Compassion fatigue has clear emotional and physical costs and significant impacts on staff recruitment and retention. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: This review is the first to evaluate the quantitative literature on compassion fatigue in mental health nurses. Research on compassion fatigue in mental health nurses does not accurately account for the unique care relationship between nurse and consumer. Competency-based education, strong mental health nurse leadership, positive organizational cultures, clinical supervision and reflection alongside individual self-care strategies may mitigate compassion fatigue. WHAT ARE THE IMPLICATIONS FOR FUTURE PRACTICE?: Resources are urgently needed for education and workforce development that addresses compassion fatigue in mental health nurses. Interventions addressing the physical, cognitive and emotional demands of care work are needed to ensure mental health nurses have the capability to provide sustainable compassionate care to consumers. ABSTRACT: Introduction Although compassionate care is an essential component of mental health nursing, understandings of the impact of compassion fatigue is poorly understood. Aims/Questions To examine and synthesize available data on the prevalence of compassion fatigue within mental health nurses and consider what variables impact compassion fatigue. Method A search of MEDLINE, EMBASE, PsychINFO, Emcare, Web of Science, Scopus, CINAHL and grey literature for articles published between 1992 and February 2021 was conducted. Data were extracted from articles meeting inclusion criteria and integrated using narrative synthesis. Results Twelve articles were included. Prevalence of compassion fatigue ranged from low to high. Variables were identified that may mitigate the risk of compassion fatigue. Strong leadership and positive workplace cultures, clinical supervision, reflection, self-care and personal well-being may protect mental health nurses against compassion fatigue. Discussion Future research is needed on mental health nurses lived experience of compassion fatigue and their understandings of compassion. Implications for Practice Interventions should focus on increasing awareness of compassion fatigue and building individual and organizational resilience. Both organizations and individuals should be aware of the role they play in maintaining the capacity and capability for mental health nurses to provide sustainable and compassionate mental healthcare.

Exploring the frequency, duration and experience of seclusion for women in a forensic mental health setting: a mixed-methods study protocol.

INTRODUCTION: Seclusion use is high in forensic mental health settings and is associated with avoidable physical and psychological harm. The use of seclusion causes significant distress and trauma for those secluded and women in these settings are particularly vulnerable. This study protocol aims to identify factors associated with the use of seclusion and the experience of seclusion for women in forensic mental health settings. METHODS AND ANALYSIS: This study will use a prospective mixed-methods design. Quantitative data on the frequency and duration of seclusion and potential explanatory demographic and clinical variables will be collected prospectively from consecutive medical records of women admitted to a forensic mental health service over a 2-year period. Data will be analysed using descriptive statistics and logistic regression techniques. Qualitative data will be collected from individual face-to-face semistructured interviews with women who have experienced seclusion about the reason for seclusion, whether they agreed with the reason for seclusion, their experience of the seclusion event and the seclusion environment and support provided while in seclusion using qualitative description methods. Data will be analysed using thematic analysis. ETHICS AND DISSEMINATION: Ethical approval has been granted by the University of Newcastle Human Research Ethics Committee (H-2019-0122) and organisational support granted from the participating forensic mental health service. Participation will be voluntary and written informed consent is required. Results will be disseminated via the first author's doctoral thesis, in peer-reviewed journals and at conferences. Results will inform recommendations for policy, and evidence for timely and specific interventions to support the reduction of seclusion for women in forensic mental health settings.

The impact of an undergraduate students' culture on their learning about mental health: A scoping review.

Mental disorders are highly prevalent. This necessitates undergraduate students in health-related courses are provided with the knowledge, skills, and attitudes to deliver safe care. Research confirms undergraduate health students maintain discriminative, stigmatizing, and inaccurate beliefs and attitudes toward those experiencing mental disorders. However, there is a paucity of research exploring how culture influences these beliefs. This scoping review addressed the question: 'What is the impact of an undergraduate student's culture on their learning about mental health?' A systematic search was undertaken of the MEDLINE, CINAHL, Scopus, PsycINFO, and ERIC databases. Results indicate variance between students' cultural beliefs in their attitudes toward and knowledge of mental disorders and understanding of interventions and treatment. None of the identified studies reviewed the ramifications for pedagogy beyond anecdotal suggestions. Educators need to acknowledge the potential impact that students' cultural beliefs have on their learning about mental health and consider appropriate learning activities to acknowledge the role of culture. Research of the impact of undergraduate students' culture on their learning about mental health will provide an evidence base for the development of these learning activities.