Registered nurses within public mental health services play crucial roles in helping people recover from suicidal crisis. However, there is a lack of understanding of how care is experienced in this context, and available evidence suggests that nurses and consumers are often dissatisfied with the quality of care. There is thus an imperative to generate understanding of needs and experiences of both groups with a view to informing practice development. This article summarizes qualitative findings from a multimethod study undertaken in Australia, which surveyed and interviewed mental health nurses who had recent experience of caring for consumers in suicidal crisis in a hospital setting, and interviewed consumers who had recovered from a recent suicidal crisis. A framework was developed to guide the study and support ethical imperatives; in particular, the promotion of consumer well-being. The findings highlight that therapeutic interpersonal engagement between nurses and consumers was central to quality care. This was particularly noted, as engagement could help reduce consumer isolation, loss of control, distress, and objectification of the delivery of potentially-objectifying common interventions. Of concern, the results indicate a lack of therapeutic engagement from the perspective of both consumers and nurses. Recommendations to promote fuller therapeutic engagement are presented.

Forming interpersonal therapeutic relationships with mental health Service Users remains a key aspect of the practice of Psychiatric/Mental Health nurses. Given the omnipresence of the concept within the relevant literature the reader could be forgiven for asking: why would Psychiatric/Mental Health nurses opine about something so basic, so ubiquitous and so central to the theory and practice of our discipline? While the authors could locate no substantive argument that refutes the role or value of such relationships, a sizable, growing and reasonably consistent body of work has emerged, which appears to indicate that this centrality and value is not necessarily reflected in many clinical practice settings. Accordingly, we draw on the published evaluations of mental health care emanating from the United Kingdom, Portugal, Canada, Switzerland, Germany and Australia, compare these findings and highlight similarities or/and congruence and discuss a range of issues arising out of the findings. Alas, the findings seem to depict a mental health care inpatient experience that is often devoid of warm therapeutic relationships, respectful interactions, information or choice about treatment and any kind of formal/informal 'talk therapy'. Instead such care experiences are personified by: coercion, disinterest, inhumane practices, custodial and controlling practitioners and a gross over use of pharmacological 'treatments'.

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ObjectiveTasmania is one of the 12 Australian sites chosen to participate in the National Suicide Prevention Trial. The Centre for Rural Health, University of Tasmania, was contracted to conduct a local‐level, process evaluation of this initiative using a Participatory Action Research approach, with the objective of this article to summarise progress and key learnings from the local evaluation to date.DesignEmpowerment and Utilisation‐Focus Evaluation theoretical approaches informed the conduct of process evaluation activities, within an overarching participatory action research approach.SettingThree participating regions in Tasmania were included as follows: Launceston, the North‐West and Break O'Day.ParticipantsWorking group members, service providers and other relevant stakeholders.InterventionsMixed‐methods surveys, field observations and content analysis were conducted.ResultsSurvey results indicated that most working group members understood the concept of a “systems‐based” approach to suicide prevention. Most participants believed that working group structures/functions engaged community members with lived experience, while around half believed that these structures/functions facilitated relationships with local services and that working group action plans adequately addressed issues of capacity building and sustainability. Preliminary field data suggested that awareness raising, engagement and face‐to‐face capacity‐building activities focused on the wider community were preferred to activities targeting specific populations.ConclusionThese preliminary findings suggest ambivalence among key stakeholders concerning the application of a systems‐based approach to suicide prevention in regional areas of Tasmania. Consistent with a participatory action research approach, the findings will inform the evolution of trial site activity for the remainder of the trial and, in due course, the implementation of future such initiatives.

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