Trauma-informed mental health practice during COVID-19: Reflections from a Community of Practice initiative.

This article discusses insights arising from a Community of Practice (CoP) initiative within a mental health short stay inpatient unit adjacent to a major Emergency Department to explore how COVID-19 has influenced engagement and support of people in mental distress. The present initiative was designed as a collaboration between the University of South Australia and SA Health. Community of Practice (CoP) is combined with a narrative review of current evidence to explain specific nursing care responses within an operating environment of pandemic-induced fear and uncertainty. Meetings discussed the challenges associated with delivering mental health care for people experiencing mental health distress in the COVID-19 context. Applying trauma-informed principles to mental health care delivery was identified to be of relevance in the context of an ongoing pandemic. Humanizing nursing care and increasing people's sense of predictability and safety contributed to therapeutic engagement and support during COVID-19. Factors discussed to mitigate the effects of safety measures include, for example, nuanced verbal and non-verbal engagement of health workers with people in mental distress when wearing personal protective equipment (PPE). We highlight the need to 'humanise' nursing and openly communicating that both practitioners and people in distress are navigating special circumstances. The CoP participants additionally acknowledged that the experience of moral distress among frontline health workers needs to be addressed in future policy responses to COVID-19. Person-centred and trauma-informed responses at the point of care might help to mitigate the pandemic short- and long-term effects for both service users and frontline health workers.

Face to face, person to person: Skills and attributes deployed by rural mental health clinicians when engaging with consumers.

OBJECTIVE: The purpose of this study was to identify the skills and attributes deployed by rural mental health clinicians when engaging with consumers in the community mental health context. DESIGN: Reflecting the exploratory nature of this research, a semi-structured focus group was conducted. SETTING: One community mental health service in regional South Australia (catchment area = approximately 60 000 people). PARTICIPANTS: Nine mental health clinicians. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Participants' focus group comments were explored qualitatively using thematic analysis. RESULTS: Three major themes were identified: (i) limitations to providing mental health care in the rural environment (increased consumer vulnerability, limited services, increased risk, and stigma); (ii) universal engagement approaches (being consumer-focused, appropriate communication, facilitating a connection and normalising the experience); (iii) indicated and targeted strategies for engagement (flexible and creative delivery of care, a whole of community approach, being multiskilled and technology use). CONCLUSIONS: Although engaging with consumers involves many skills and attributes employed universally across mental health settings, the rural clinician's ability to navigate the environment and utilise this to provide consumer care is equally important to the engagement process. Specifically, these findings highlight the preference of rural mental health clinicians towards a person-centred approach, networking with others in the community when providing care. Understanding how best to maximise the nature of a rural environment, such as facilitating relationships between clinicians and others in the community, will contribute to optimised care.

Engaging consumers in the Australian emergency mental health context: a qualitative perspective from clinicians working in the community.

Successfully engaging with consumers is seen as an essential component of mental healthcare, yet doing so can be challenging and little is understood about the unique engagement skills and attributes employed by mental health clinicians working in the emergency community context. Consequently, this qualitative study explored the engagement experiences of clinicians to identify the attributes used when engaging with consumers in this unique setting. We conducted two semi-structured focus groups in July and August 2011 with 16 clinicians employed at one metropolitan mental health organisation in South Australia. Using thematic analysis, we identified two key themes pertaining to the skills and attributes used for successful consumer engagement: (i) building trust, through communication style, an honest approach, facilitating choice and locating trust networks; and (ii) portraying genuine care, through showing respect, offering practical assistance and taking the least restrictive pathway. These findings highlight the unique nature of engagement in the emergency community mental health setting, as well as the flexibility and resourcefulness required to facilitate it.