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July 2020

This bulletin includes recent articles and reports from selected journals and websites on the topic of Mental Health. This is not an exhaustive list and if you require further information on a

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In this issue

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MENTAL HEALTH

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Articles

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Key Journals

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Effect of screening, brief intervention and referral to treatment for unhealthy alcohol and other drug use in mental health treatment settings: a randomized controlled trial

Author(s): Karno M.P.; Rawson R.; Grella C.; Mooney L.J.; Glasner S.; Rogers B.; Spear S.; Saitz R.; Kagan B.

Source: Addiction; 2020

Available at Addiction (Abingdon, England) - from Wiley Online Library Medicine and Nursing Collection 2019 - NHS

Abstract:Aims: To test the efficacy of a brief intervention to reduce alcohol or drug use and to promote use of addiction services among patients seeking mental health treatment. Design and setting: A multi-centre, longitudinal, two-group randomized controlled trial with randomization within each of two mental health treatment systems located in Ventura County and Los Angeles County in California, USA. Participant(s): A total of 718 patients (49.2% female) aged 18 and older with a mental health diagnosis and either a heavy drinking day or any use of cannabis or stimulants in the past 90 days. Intervention and comparator: A motivation-based brief intervention with personalized feedback (screening, brief intervention and referral to treatment (SBIRT) condition) (n = 354) or a health education session (control condition) (n = 364). Measurements: Primary outcomes included frequency of heavy drinking days, days of cannabis use and days of stimulant use at the primary end-point 3 months post-baseline. Secondary outcomes included frequency and abstinence from substance use out to a 12-month follow-up and the use of addiction treatment services. Finding(s): Participants in the SBIRT condition had fewer heavy drinking days [odds ratio (OR) = 0.53; 95% credible interval (CrI) = 0.48-0.6] and fewer days of stimulant use (OR = 0.58; 95% CrI = 0.50-0.66) at the 3-month follow-up compared with participants in the health education condition. Participants in the SBIRT condition did not comparatively reduce days of cannabis use at the 3-month follow-up (OR = 0.93; 95% CrI = 0.85-1.01). Secondary outcomes indicated sustained effects of SBIRT on reducing the frequency of heavy drinking days and days of stimulant use. No effects were observed on abstinence rates or use of addiction treatment services. Conclusion(s): Screening and brief intervention for unhealthy alcohol and drug use in mental health treatment settings were effective at reducing the frequency of heavy drinking and stimulant use.

Impact of suicide on health professionals in psychiatric care mental healthcare professionals' perceptions of suicide during ongoing psychiatric care and its impacts on their continued care work

Author(s): Rytterstrom P.; Wardig R.; Hultsjo S.; Ovox S.M.

Source: International Journal of Mental Health Nursing; 2020

Available at International Journal of Mental Health Nursing - from Wiley Online Library Medicine and Nursing Collection 2019 - NHS

Articles

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Available at International Journal of Mental Health Nursing - from Unpaywall

Abstract:People who attempt suicide as well as those who actually take their own life often have communicated their suicidal thoughts and feelings to healthcare professionals in some form. Suicidality is one of the most challenging caring situations and the impacts of suicide care affect both the professional and personal lives of healthcare professionals. This study investigates how mental health professionals perceive suicide while providing psychiatric care and how this perception impacts their continued care work. This qualitative exploratory study includes 19 mental health professionals in psychiatry who had provided care for patients who had taken their own life. Analysis followed the principle of phenomenography. The findings reveal that these healthcare professionals experienced an internal conflict that affected them both personally and professionally. In response to these conflicts, the healthcare professionals developed strategies that involved a safety zone and increased vigilance. Those who were able to commute and balance a safe spot and learning to be more vigilant seem to have developed as a result of patient's suicide. These findings have the potential to help establish a post-suicide caring process where healthcare professionals learn to make better suicide assessments, become more open to talking about death with patients, and develop a humbler approach to understanding a patient's suicide.

Conceptualizing an Islamic psychotherapy: A grounded theory study

Author(s): Rothman, Abdallah; Coyle, Adrian

Source: Spirituality in Clinical Practice; Jun 2020

Available at Spirituality in Clinical Practice - from Unpaywall

Abstract:Many religiously committed Muslims do not seek psychotherapeutic services because of assumptions that psychotherapists will not engage with their religious values in an informed and open way. In light of this, an approach to psychotherapy is needed that explicitly values Muslims’ religious orientations and commitments and integrates these into clinical practice. The present study builds upon an Islamic model of the soul to develop a data-grounded, experience-based model of Islamic psychotherapy. It does this by adopting a grounded theory approach to the analysis of interviews with 18 Muslim psychotherapists from six countries (12 men and six women) who believed that they integrate Islamic conceptions of psychology into their clinical practice. The ways in which participants understood and applied the four levels of the structure of the soul (the nafs, or "lower self"; the aql, or "intellect"; the qalb, or "heart"; and the ruh, or "spirit") in formulating an Islamic psychotherapy are examined. Their conceptualizations and reports of practice spoke of a holistic psychology with an emphasis on embodiment, and of psychological difficulties as occurring because of blockages or imbalances at the levels of the soul. These were seen as needing to be released to enable clients to align more closely with their pure and good nature that comes from and is connected to God. Participants expressed caution about overstepping their knowledge and expertise and venturing into deep religious guidance. From these insights, an "iceberg model" of Islamic psychotherapy is developed.

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Computer use in mental health treatment: Understanding collaborative documentation and its effect on the therapeutic alliance

Author(s): Matthews, Elizabeth B.

Source: Psychotherapy; Jun 2020; vol. 57 (no. 2); p. 119-128

Available at Psychotherapy (Chicago, Ill.) - from ProQuest PsycARTICLES - NHS

Abstract:Amid increases in electronic health record adoption, many psychotherapists are concerned that in-session computing may harm the client–provider relationship, also known as the therapeutic alliance. The emerging practice of collaborative documentation (CD) is one strategy designed to prevent this outcome. Little empirical work has examined the effects of in-session computing generally or CD specifically within the psychotherapeutic context. This study explores how CD is being implemented in psychotherapy and examines how both the frequency of computing and the use of CD affects the therapeutic alliance. Psychotherapists in this study engaged in an average of 42 (SD = 38.5) computing episodes. CD was present in 39% of sessions (N = 21). Regression models found that among providers, increases in computing frequency predicted decreases in alliance (ß = −.18, p < .05). Conversely, among clients, the use of CD improved alliance (ß = .43, p < .01). Findings suggest that psychotherapists use computers often, but parties view the effect of electronic health records differently. Reconciling this disparity and continuing to develop effective technology-based best practices is imperative.

Impact statementClinical Impact Statement—Question: This study examines how both the frequency and manner of computer use during psychotherapeutic sessions affects client and provider ratings of the therapeutic alliance. Findings: Findings suggest that clients and providers view the impact of in-session computing differently; when used collaboratively, computers may enhance client ratings of alliance, while providers associate increases of computer use with lower ratings of alliance. Meaning: Understanding differential responses towards in-session computer use can help guide providers’ decision-making related to effective use of technology in treatment. Next Steps: Additional work is needed to better refine approaches toward collaborative computer use, including the identification of mechanisms that will support providers in this practice.

Eliciting recovery narratives in global mental health: Benefits and potential harms in service user participation

Author(s): Kaiser, Bonnie N.; Varma, Saiba; Carpenter-Song, Elizabeth; Sareff, Rebecca; Rai, Sauharda; Kohrt, Brandon A.

Source: Psychiatric Rehabilitation Journal; Jun 2020; vol. 43 (no. 2); p. 111-120

Available at Psychiatric rehabilitation journal - from ProQuest PsycARTICLES - NHS

Abstract:Objective: The engagement of peers and service users is increasingly emphasized in mental health clinical, educational, and research activities. A core means of engagement is via the sharing of recovery narratives, through which service users present their personal history of moving from psychiatric disability to recovery. We critically examine the range of contexts and purposes for which recovery narratives are elicited in global mental health. Method: We present 4 case studies that represent the variability in recovery narrative elicitation, purpose, and geography: a mental health Gap Action Programme clinician training program in Nepal, an inpatient clinical service in Indian-controlled Kashmir, a recovery-oriented care program in urban Australia, and an undergraduate education program in the rural United States. In each

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case study, we explore the context, purpose, process of elicitation, content, and implications of incorporating recovery narratives. Results: Within each context, organizations engaging service users had a specific intention of what "recovery" should constitute. This was influenced by the anticipated audience for the recovery stories. These expectations influenced the types of service users included, narrative content, and training provided for service users to prepare and share narratives. Our cases illustrate the benefit of these coconstructed narratives and potential negative impacts on service users in some contexts, especially when used as a prerequisite for accessing or being discharged from clinical care. Conclusions and Implications for Practice: Recovery narratives have the potential to be used productively across purposes and contexts when there is adequate identification of and responses to potential risks and challenges.

Impact statementImpact and Implications—Programs engaging with mental health service users to share their recovery narratives can reduce stigma, facilitate healing, and promote engagement in mental health care. Yet there are risks to mitigate. Such programs should provide adequate preparation for service users, accommodate diversity of recovery experiences, be transparent regarding cocreation of narratives, attend to context, and ensure that recovery narratives are never prerequisites for discharge or other clinical decisions.

Immigration, acculturation, and preferred help-seeking sources for depression: comparison of five ethnic groups

Author(s): Markova V.; Sandal G.M.; Pallesen S.

Source: BMC health services research; Jul 2020; vol. 20 (no. 1); p. 648

Available at BMC health services research - from Europe PubMed Central - Open Access

Available at BMC health services research - from ProQuest (Health Research Premium) - NHS Version

Abstract:BACKGROUND: Immigrants are more likely than the majority population to have unmet needs for public mental health services. This study aims to understand potential ethnic differences in preferred help-seeking sources for depression in Norway, and how such preferences relate to acculturation orientation. METHOD(S): A convenience sample of immigrants from Russia (n =164), Poland (n =127), Pakistan (n =128), and Somalia (n =114), and Norwegian students (n =250) completed a survey. The sample was recruited from social media platforms, emails, and direct contact. The survey consisted of a vignette describing a moderately depressed person. Respondents were asked to provide advice to the person by completing a modified version of the General Help-Seeking Questionnaire. The immigrant sample also responded to questions about acculturation orientation using the Vancouver Index of Acculturation Scale. RESULT(S): Significant differences were found in the endorsement of traditional (e.g., religious leader), informal (e.g., family), and semiformal (e.g., internet forum) help-sources between immigrant groups, and between immigrant groups and the Norwegian respondent group. Immigrants from Pakistan and Somalia endorsed traditional help sources to a greater extent than immigrants from Russia and Poland, and the Norwegian student sample. There were no ethnic differences in endorsement of formal mental help sources (e.g., a medical doctor). Maintenance of the culture of origin as the acculturation orientation was associated with preferences for traditional and informal help sources, while the adoption of mainstream culture was associated with semiformal and formal help-seeking sources. CONCLUSION(S): Ethnic differences in help-seeking sources need to be considered when designing and implementing mental health services.

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Where do I turn for help? Gender role conflict, self-stigma, and college men’s help-seeking for depression

Author(s): Cole, Brian P.; Ingram, Paul B.

Source: Psychology of Men & Masculinities; Jul 2020; vol. 21 (no. 3); p. 441-452

Available at Psychology of Men & Masculinities - from ProQuest PsycARTICLES - NHS

Abstract:Experiences of self-stigma and gender role conflict act as barriers to men’s psychological help-seeking. Although previous studies suggest that violation of masculine norms and the desire to preserve masculinity reduce men’s help-seeking behaviors, little is known about the ways in which specific help-seeking behaviors are impacted. The current study examined relations between gender role conflict, self-stigma, and help-seeking for depression among a sample of college men from a Midwestern university in the United States (N = 313). Participants engaged in a role induction based upon a vignette about a man with depression and were asked the types of help-seeking behaviors they would engage in (i.e., professional help, self-help, informal help, or avoidant behaviors). Results of this study indicate that gender role conflict and self-stigma have different relations to help-seeking behaviors. More specifically, (a) gender role conflict plays an incremental role beyond mental health self-stigma in understanding certain types of responses to mental health needs, (b) there is a positive relationship between experiencing gender role conflict and holding increasingly self-stigmatizing views, (c) self-stigma and gender role conflict differ in their pattern of influence for mental health treatment responses, (d) gender role conflict corresponds with increased avoidant behaviors and decreases social support utilization, and (e) self-stigma predicts decreased social support and professional help utilization while also increasing avoidant behaviors. Although gender role conflict and self-stigma had unique relations to professional help-seeking for depression, utilization of social support was negatively impacted by both. Considerations for help-seeking patterns in men and the influence of both stigmatized social views and conflicting gender roles are discussed.

Impact statementPublic Significance Statement—This study suggests that men’s experiences of gender role conflict and self-stigma of help-seeking are associated with their decisions to utilize self-help, to talk with friends and family, and to seek professional help when depressed.

Using multiple measures of openness to experience to capture positive, negative, and disorganized dimensions of schizotypy

Author(s): Kemp, Kathryn C.; Burgin, Chris J.; Raulin, Michael L.; Kwapil, Thomas R.

Source: Personality Disorders: Theory, Research, and Treatment; Jul 2020; vol. 11 (no. 4); p. 260-269

Available at Personality disorders - from ProQuest PsycARTICLES - NHS

Abstract:The underlying vulnerability for schizophrenia-spectrum disorders is expressed across a continuum of clinical and subclinical symptoms and impairment known as schizotypy. Schizotypy is a multidimensional construct with positive, negative, and disorganized dimensions. Models of normal personality provide useful frameworks for examining the multidimensional structure of schizotypy. However, the relationship of schizotypy with openness to experience has been largely limited to studies using the five-factor model of personality, which may not adequately capture maladaptive expressions of openness. Therefore, this study examined the relationship of positive, negative, and disorganized schizotypy with multiple measures of openness that

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capture adaptive and maladaptive aspects of the construct. MTurk and university participants ( n = 1,281) completed the Multidimensional Schizotypy Scale and five measures of openness. As hypothesized, positive schizotypy was generally associated with elevated openness, especially measures tapping oddness and eccentricity, whereas negative schizotypy was inversely associated with openness, especially measures assessing openness to feelings. Disorganized schizotypy was generally unassociated with openness. Principal components analysis of 15 openness facets revealed four factors: Fantasy/Feelings, Ideas, Eccentricity, and Nontraditionalism, and provided more nuanced understanding of the associations of schizotypy and openness. Positive schizotypy was associated with each factor (albeit inversely with Nontraditionalism), negative schizotypy was inversely associated with Fantasy/Feelings but positively associated with Eccentricity, and disorganized schizotypy was only associated with Eccentricity. These results support the construct validity of the Multidimensional Schizotypy Scale and highlight that the association of schizotypy and openness is best understood by considering the multidimensionality of both constructs and evaluating adaptive and maladaptive openness.

A randomized controlled trial of the effectiveness of virtually delivered Body Project (vBP) groups to prevent eating disorders

Author(s): Ghaderi, Ata; Stice, Eric; Andersson, Gerhard; Enö Persson, Johanna; Allzén, Elin

Source: Journal of Consulting and Clinical Psychology; Jul 2020; vol. 88 (no. 7); p. 643-656

Available at Journal of consulting and clinical psychology - from ProQuest PsycARTICLES - NHS

Abstract:Objectives: To investigate the effectiveness of Body Project groups delivered virtually (vBP) by peer educators for prevention of eating disorders. Method: In a randomized controlled trial vBP groups (N = 149) were compared with a placebo (expressive writing, EW: N = 148) over 24-month follow-up and to a waitlist control condition (N = 146) over 6-month follow-up among females (15–20 years old) with body image concerns. The primary outcome was incidence of eating disorder onset over 2-year follow-up measured by blinded diagnostic interviews. Waitlist participants were offered the vBP after 6 months. Results: The incidence of eating disorders onset over 24 months follow up were 3 in vBP (2.0%) and 13 in EW (8.8%), a significant difference; Hazard Ratio (Experiment B) = 0.26, 95% confidence interval (CI) [0.075, 0.92], p = .037. Incidence of eating disorder onset in vBP participants was 77% less than in EW participants. The vBP participants generally showed significantly greater reduction in eating disorder symptoms, clinical impairment, body dissatisfaction, and internalization of thin ideal compared with the waitlist participants at postintervention and 6-month follow-up, and in eating disorder symptoms, restraint, body dissatisfaction, and internalization of thin ideal compared with the EW participants at postintervention, and 6-, 12-, 18-, or 24-months follow-up. EW participants reported significantly greater reduction in clinical impairment and body dissatisfaction at postintervention compared with the waitlist participants. Conclusions: The present reduction in the incidence of eating disorders is notable given that the intervention was implemented virtually, rather than in-person. The vBP might be a viable option for future evaluation of scalable prevention of eating disorders.

Impact statementWhat is the public health significance of this article?—Results suggests that the Body Project prevention program, when delivered through virtual groups (vBP), significantly reduces risk factors, eating disorder symptoms, and future eating disorder onset. This format of

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delivery has the potential to allow broader implementation of this effective eating disorder prevention program.

Common and differential dimensions of personal identity between psychosis and depression: The relevance of gender and depressive mood

Author(s): García-Mieres, H.; Montesano, A.; Villaplana, A.; Trujillo, A.; Salla, M.; Paz, C.; Ochoa, S.; Feixas, G.

Source: Journal of Psychiatric Research; Aug 2020; vol. 127 ; p. 48-56

Abstract:Disturbances in personal identity are recognized in psychosis and depression. However, it is unknown whether these disruptions share common processes across clinical groups, or whether there are unique alterations by group or between men and women within each clinical group. To advance on this question, we compared personal identity dimensions in psychosis and depression and investigated the effects of gender and depressive mood. This study assessed dimensions of personal identity using the repertory grid technique among 85 outpatients with psychosis, 85 outpatients with depressive disorders and 85 healthy controls who were matched by age. Data regarding depressive mood and general functioning was also collected. Results showed that self-discrepancies were higher in psychosis and depression than in controls, and were associated with depressive mood. Interpersonal dichotomous thinking was more prevalent in women in both clinical groups. Women with psychosis showed higher ideal-others discrepancy and had a more complex structure of personal identity than their male counterparts. To conclude, alterations in self-ideal and self-others discrepancies may be transdiagnostic dimensions related to depressive mood. Interpersonal dichotomous thinking may also be a common dimensional characteristic in psychosis and depression but more specific to women. Finally, critical views of others and a higher complexity of personal identity may be more specific to women than men with psychosis. Our results are consistent with other studies pointing to the need for person-focused treatments promoting the recovery of a full sense of personal identity, rather than just focusing on specific thoughts and feelings.

Predicting relapse in patients with severe alcohol use disorder: The role of alcohol insight and implicit alcohol associations

Author(s): Dandaba, Meira; Serra, Wilfried; Harika-Germaneau, Ghina; Silvain, Christine; Langbour, Nicolas; Solinas, Marcello; Noël, Xavier; Jaafari, Nemat; Chatard, Armand

Source: Addictive Behaviors; Aug 2020; vol. 107

Available at Addictive Behaviors - from Unpaywall

Abstract:Low insight is reported as a risk factor for relapse among patients treated for alcohol use disorders. However, to date, little is known on why patients with low insight are at higher risk for relapse. In this study, we tested the hypothesis that an implicit preference for alcohol over abstinence predicts relapse in patients with low, but not high, alcohol insight. Participants consisted of 77 patients who had received treatment for severe alcohol use disorder in a hospital in France. During hospitalization, they completed a self-report measure of insight and an implicit association test to assess implicit preference for alcohol over abstinence. The primary outcome was relapse assessed one month after discharge. Control variables were gender, age, cognitive deficit, anxiety, depression, craving, and impulsivity. Data were analysed using logistic regression analysis. After adjusting for demographic and clinical variables, relapse was predicted

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by the interaction between insight and implicit preference for alcohol but not by their main effects alone. Implicit preference for alcohol predicted relapse among patients with relatively low insight, but not among those with relatively high insight. These findings suggest that patients with low insight and strong implicit preference for alcohol are at a higher risk of relapse. Clinicians may therefore focus on and tailor specific interventions to prevent relapse in this vulnerable and at-risk population.

"Talk about it:" changing masculinities and mental health in rural places?

Author(s): Herron ; Ahmadu, Mairo; Allan, Jonathan A.; Waddell, Candice M.; Roger, Kerstin

Source: Social Science & Medicine; Aug 2020; vol. 258

Abstract:Rural men's mental health has been described by some scholars as a "silent crisis." Rural men report lower levels of stress and depression and, paradoxically, much higher rates of suicide and substance use. Research has linked rural men's silence to dominant forms of masculinity with limited consideration of how masculinities are changing within and across rural places. In this article, we draw together literature on changing masculinities, rural places, and rural men's mental health to explore how, where, and with whom rural men talk about mental health; as well as their perspectives of what it means to be a healthy man. To collect in-depth information about men's perceptions and experiences of mental health and masculinity, the study employed semi-structured interviews with 23 adult male participants (aged 20-79 years) in Manitoba, Canada. Men in the study described the complex dynamics of talking about mental health with spouses, other family members, friends, and in the community. Many men wanted to talk about their mental health and some men actively developed relationships to support "talking about it;" however, they also identified competition, gossip, and stigma in relation to talking about mental health in the community. Most men in the study resisted hegemonic masculinities and some men aspired to more balanced, relational, and caring ideals. Men in the study identified community and environmental challenges to talking about mental health and changing masculinities in rural places. We argue that addressing the so-called silent crisis of rural men's mental health requires greater attention to community change and rural development to support relationships and places to talk about mental health. • Rural men's mental health has been described as a "silent crisis". • Men in our study expressed a desire to talk about their mental health. • Men in our study identified challenges talking about mental health in rural spaces. • Rural community development is critical to addressing the so-called "silent crisis".

Reaching out to big losers leads to sustained reductions in gambling over 1 year: a randomized controlled trial of brief motivational contact.

Author(s): Jonsson ; Hodgins, David C.; Munck, Ingrid; Carlbring, Per

Source: Addiction; Aug 2020; vol. 115 (no. 8); p. 1522-1531

Available at Addiction - from Wiley Online Library Medicine and Nursing Collection 2019 - NHS

Available at Addiction - from Unpaywall

Abstract:Background and aims: A previous randomized controlled trial demonstrated that telephone- and letter-based motivational interventions with high-expenditure gamblers had significant short-term positive effects on gambling and use of responsible gambling tools. This post-trial follow-up examined outcomes in gambling expenditure over 12 months. Design

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Observational study following a three-arm randomized controlled trial. Setting: Customers of Norsk Tipping (NT) gambling platforms, Norway. Participants: A total of 1003 statistical triplets from the top 0.5% of customers based upon annual expenditure, matched on sex, age and net losses. Mean age was 53.4 years; 19% were women, mean yearly loss for 2016 was 88 197 NoK. Interventions and comparator Feedback intervention by telephone, letter or a no-contact control condition. Measurements Primary outcome measure was gambling theoretical loss, derived from the NT customer database. Secondary outcomes were responsible gambling customer actions and whether or not the participant was retained as an NT customer. Findings Per-protocol analyses of triplets who received the telephone call or letter as randomly assigned (n = 596) showed a positive and sustained effect over 12 months: the telephone group showed a 30% reduction in theoretical loss (d = 0.44) and the letter group 13% (d = 0.18), both outperforming the control group with a 7% reduction (d = 0.11). The telephone condition was superior to both the letter and control conditions in per-protocol (P < 0.001) and to control condition in intention-to-treat analyses (ITT) (P < 0.001). Individuals in the telephone condition took more responsible gambling actions. The letter condition had better outcomes than the control in the ITT-only analysis (P < 0.001). More than 93% were still customers a year after the intervention. Conclusions: Personal contact with high-expenditure gambling customers in Norway that provided individualized feedback on expenditures was associated with reduced theoretical losses and greater use of responsible gambling tools over a 12-month period, compared with no contact. Telephone intervention with customers had a larger impact than a mailed letter.

The conditions of possibilities for recovery: A critical discourse analysis in a Danish psychiatric context.

Author(s): Jørgensen ; Praestegaard, Jeanette; Holen, Mari

Source: Journal of Clinical Nursing (John Wiley & Sons, Inc.); Aug 2020; vol. 29 (no. 15/16); p. 3012-3024

Available at Journal of clinical nursing - from Wiley Online Library Medicine and Nursing Collection 2019 - NHS

Abstract:Aims and objectives: This paper explores the conditions for the possibilities of recovery in a Danish mental healthcare practice, expressed from the perspective of nurses. The results and discussion of the study help to make visible and explore the muddle of conceptualisations of recovery in mental healthcare practice. Background: Few studies examine the possibilities of recovery for inpatients and outpatients in mental health centres from a nursing perspective. Design: A qualitative design using a critical social constructionist frame of understanding, in which the real world is considered as a series of social constructions. Method: A Fairclough-inspired critical discourse analysis was chosen as the analytical strategy. The analysis is comprised of ten interviews in mental health care and notes, written by nurses, in medical records of ten patients with a mental illness admitted to a mental healthcare centre in 2016–2017. The Consolidated Criteria for Reporting Qualitative Research checklist was used as a guideline to secure accurate and complete reporting of the study (See Appendix S1). Results: From the findings of the textual analysis and the analysis of the discourse practice, it seems clear that the social relations and structures relating to recovery in Danish psychiatry are steered and controlled by discourses that reflect, in general terms, the essence of the core of neoliberal ideology. Conclusion: Recovery is generally articulated from an overall discourse of neoliberalism with its embedded discourses of paternalism, biomedicine, self-care and holism.

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All these discourses coexist in nursing practice, but the paternalistic discourse becomes the framework for the conditions for the possibility of how recovery is expressed in practice. Relevance to clinical practice: Nurses need to be supported to seek clarity in the understanding and operationalisation of a recovery-oriented approach, if the agenda is to be truly adopted and strengthened.

Activities on acute mental health inpatient wards: A narrative synthesis of the service users’ perspective

Author(s): Foye, Una; Li, Yan; Birken, Mary; Parle, Kayleigh; Simpson, Alan

Source: Journal of Psychiatric and Mental Health Nursing; Aug 2020; vol. 27 (no. 4); p. 482

Available at Journal of psychiatric and mental health nursing - from Wiley Online Library Medicine and Nursing Collection 2019 - NHS

Abstract:BackgroundConcern about the lack of activities on mental health inpatient wards is long-standing with reports consistently finding that service users receive insufficient access to a range of activities and report high levels of boredom. There is recognition that little is known about what service users want when admitted to inpatient wards.AimThis review seeks to understand service users’ experiences and views in relation to the provision and availability of activities, and to explore the perceived benefits and barriers to service users.MethodsWe searched multiple databases (Scopus, MEDLINE, CINAHL, PsycINFO and Embase) for studies that evaluated activities on acute adult inpatient mental health wards. We identified 12 papers across a range of methodological designs from which the narrative synthesis has been analysed.ResultsFindings show that the provision of activities is unsatisfactory for many service users, which in turn is related to increased boredom that has a negative impact on service users’ well-being. We explore the benefits and barriers to engagement, providing an insight into the aspects that make an activity important.ConclusionThere are few studies exploring the needs of service users regarding activity provision; therefore, there is limited knowledge about what is meaningful for individuals.

Moderators of treatment efficacy in individualized metacognitive training for psychosis (MCT+)

Author(s): Leanza, Letizia; Studerus, Erich; Bozikas, Vasilis P.; Moritz, Steffen; Andreou, Christina

Source: Journal of Behavior Therapy and Experimental Psychiatry; Sep 2020; vol. 68

Abstract:Background and objectives: Individualized Metacognitive Training (MCT+) is a manualized intervention designed to improve delusional severity by reducing delusion-associated cognitive biases such as jumping-to-conclusions. Increased interest in personalized medicine stipulates the identification of patients who are more likely to benefit from specialized interventions. The present study aimed to explore baseline moderators of MCT+ efficacy on delusions and overall positive symptoms in psychosis. Methods: We analyzed data from a randomized rater-blind controlled trial, in which 92 patients with psychotic disorders and current or past delusions were randomly assigned to either MCT+ or CogPack®, a cognitive remediation software. Baseline moderator variables consisted of jumping-to-conclusions, cognitive insight, quality of life, self-esteem, selective attention, and patients’ attitudes towards their symptoms. Linear mixed-effects models were applied to investigate specific moderators of MCT+ efficacy. Results: In MCT+ relative to CogPack, presence of a jumping-to-conclusions bias,

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a lowered decision threshold, and low self-esteem were associated with larger improvements in delusional severity and/or overall positive symptoms over time. Subjective reasoning style and insight, as well as subjective attitudes towards psychosis, did not moderate the treatment efficacy of MCT+ relative to CogPack. Limitations: Participation of both treatment groups in group MCT as a part of standard care, possibly leading to additional effects on delusional severity. Conclusions: Patients with low self-esteem and those who are prone to jumping-to-conclusions seem to particularly benefit from MCT+. Our results can help inform clinical practice as they provide specific criteria for selecting patients for whom MCT+ is most appropriate.

A new treatment for eating disorders combining physical exercise and dietary therapy (the PED-t): Experiences from patients who dropped out

Author(s): Bakland, Maria; Rosenvinge, Jan H.; Wynn, Rolf; Sørlie, Venke; Sundgot-Borgen, Jorunn; Mathisen, Therese Fostervold; Hanssen, Tove Aminda; Jensen, Franziska; Innjord, Kjersti; Pettersen, Gunn

Source: International Journal of Qualitative Studies on Health and Well-being; Dec 2020; vol. 15 (no. 1)

Available at International journal of qualitative studies on health and well-being - from Europe PubMed Central - Open Access

Available at International journal of qualitative studies on health and well-being - from ProQuest (Health Research Premium) - NHS Version

Abstract:Purpose: Eating disorders (ED) are complex and severe illnesses where evidence-based treatment is needed to recover. However, about half of the patients with ED do not respond to treatments currently available, which call for efforts to expand the portfolio of treatments. The aim of this study was to explore experiences from patients who dropped out of a new treatment for bulimia nervosa and binge ED, combining physical exercise and dietary therapy (PED-t). Methods: We conducted open-ended face-to-face interviews. The interviews were transcribed verbatim and the data were analysed with a phenomenological hermeneutical approach. Results: Three themes emerged: "standing on the outside", "unmet expectations" and "participation not a waste of time". Feelings of standing on the outside were elicited by being different from other group members and having challenges with sharing thoughts. Unmet expectations were related to treatment content and intensity, as well as the development of unhealthy thoughts and behaviours. Finally, some positive experiences were voiced. Conclusion: A need to clarify pre-treatment expectations and refining criteria for treatment suitability is indicated. The findings have contributed to the chain of clinical evidence regarding the PED-t and may lead to treatment modifications improving the treatment and thereby reducing drop out.

Like a bridge over troubled water—A qualitative study of professional caregiver singing and music as a way to enable person-centred care for persons with dementia

Author(s): Swall, Anna; Hammar, Lena Marmstål; Gransjön Craftman, Åsa

Source: International Journal of Qualitative Studies on Health and Well-being; Dec 2020; vol. 15 (no. 1)

Available at International journal of qualitative studies on health and well-being - from Europe PubMed Central - Open Access

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Available at International journal of qualitative studies on health and well-being - from ProQuest (Health Research Premium) - NHS Version

Abstract:Purpose: To describe the perspectives of caregivers in terms of using singing and music in their everyday work, and of their effect on care and interaction with the person with dementia. Methods: A qualitative design was used, consisting of group discussions with professional caregivers from three nursing homes in a medium-sized city in a rural area of Sweden. Results: The results demonstrate that caregiver singing and music can be powerful and useful in the care of and in communication with persons with dementia. Music, for example, can be used to facilitate socialization as it opens up for discussion, while caregiver singing was preferable when it came to the facilitation of care situations and interaction. Conclusions: Singing and music can be powerful and useful tools in the care of and in communication with persons with dementia. Regardless of whether singing or music is used, the most important factor is that a person-centred approach is adopted so as to make the music a facilitative tool. Caregiver singing and music are ways to connect with the person with dementia and an understanding of their use can contribute to dementia research. This in turn can increase awareness of the possible ways to strengthen the partnership between caregivers and persons with dementia.

Mothers’ and fathers’ lived experiences of postpartum depression and parental stress after childbirth: A qualitative study

Author(s): Johansson, Maude; Benderix, Ylva; Svensson, Idor

Source: International Journal of Qualitative Studies on Health and Well-being; Dec 2020; vol. 15 (no. 1)

Available at International journal of qualitative studies on health and well-being - from Europe PubMed Central - Open Access

Available at International journal of qualitative studies on health and well-being - from ProQuest (Health Research Premium) - NHS Version

Abstract:Purpose: The study aims are to explore the lived experiences of mothers and fathers of postpartum depression and parental stress after childbirth. Methods: Qualitative interviews conducted, and analysed from an interpretative phenomenological analysis (IPA) perspective. Results: Both mothers and fathers described experiences of inadequacy, although fathers described external requirements, and mothers described internal requirements as the most stressful. Experiences of problems during pregnancy or a traumatic delivery contributed to postpartum depression and anxiety in mothers and affected fathers’ well-being. Thus, identifying postpartum depression with the Edinburgh Postnatal Depression Scale, mothers described varying experiences of child health care support. Postpartum depression seemed to affect the spouses’ relationships, and both mothers and fathers experienced loneliness and spouse relationship problems. Experiences of emotional problems and troubled upbringing in the parents’ family of origin may contribute to vulnerability from previous trauma and to long-term depressive symptoms for mothers. Conclusions: The findings of this study demonstrate the significant impact of postpartum depression and parental stress has in parents’ everyday lives and on the spouse relationship. These results support a change from an individual parental focus to couples’ transition to parenthood in child health care.

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A narrative study of mental health recovery: Exploring unique, open-ended and collective processes

Author(s): Reed, Nina Petersen; Josephsson, Staffan; Alsaker, Sissel

Source: International Journal of Qualitative Studies on Health and Well-being; Dec 2020; vol. 15 (no. 1)

Available at International journal of qualitative studies on health and well-being - from Europe PubMed Central - Open Access

Available at International journal of qualitative studies on health and well-being - from ProQuest (Health Research Premium) - NHS Version

Abstract:Purpose: Guided by narrative theory and by use of a narrative-in-action approach, the aim of this study was to explore how mental health recovery unfolds through individuals’ engagement in everyday activities. Method: Data were created through participant observations with four individuals while doing everyday activities, and analysed through a narrative, interpretive approach. Findings: The findings show how mental health recovery involves unique and open-ended processes of narrative meaning-making, which unfold through an interplay between everyday activities, places and persons. Discussion: Based on these findings, we discuss how we may understand and support mental health recovery as collective processes.

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Aromatherapy for dementia

https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD003150.pub3/full

Rehabilitation for adults with complex psychosis

NICE guideline [NG181]Published date: 19 August 2020

https://www.nice.org.uk/guidance/ng181

Cochrane Reviews

NICE Guidlines

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