People with experience as mental health clients, mental health nurses, writers and other professionals have used literature to benefit mental health service users in various ways. These include expressive writing, as well as applications in psychotherapy and counselling and to deal with specific problems and symptoms. In addition, therapeutic story-telling, bibliotherapy and poetry therapy have been used. Various benefits have been described, but some accounts do not include evidence of clinical effectiveness. However, positive treatment outcomes have been reported in research papers and other literature, with particular evidence of clinical effectiveness in some studies of bibliotherapy, therapeutic writing and poetry therapy. Further work is needed to clarify and measure the effectiveness of various expressive and therapeutic uses of literature. The authors also recommend collaboration among practitioners and the need for supporting evidence for proposals for increased resources in this field.

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FMH nursing can be based on a wide range of sources of evidence. The types of evidence used in practice depend on individual service users' needs and views. In evaluating evidence, it is necessary to be aware of its complex, diverse nature. A distinction can be made between definitive, widely generalizable research findings and evidence with limited generalizability, requiring FMH nurses' judgments about whether it is applicable to their own area of practice. Recommendations for related education and research are made.

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