The extent of illicit substance use within inpatient mental health settings is becoming a major cause of concern. This poses growing challenges not only for the management of inpatient units, but also for providing continuity of care. Service users with co-occurring substance use are more likely to disengage from services. The process of engagement can be hindered by negative attitudes of staff. This study aimed to identify and explore multidisciplinary staff attitudes and experiences in caring for inpatients with co-occurring ill-mental health problems and illicit substance use. A questionnaire incorporating the Drug and Drugs Problems Perceptions Questionnaire (DDPPQ) was used with a non-probability sample of 84 multidisciplinary staff working on nine mental health units. Semi-structured interviews were then carried out with 10 members of staff. Overall, respondents reported: lack of training; difficulty in accessing support structures; and problematic issues with multidisciplinary decision making and processes. The DDPPQ results showed that staff who had received training held less negative attitudes towards illicit substance users regardless of their length of clinical work experience or type of work setting. Recommendations are made about the importance of training and staff support for the development of less negative attitudes towards this client group.

Accessible summary What is known on the subject CS was developed to give healthcare professionals a space to reflect, problem solve and recognise their own practice. It is different from managerial supervision as it is for the benefit of the individual staff member's personal and professional development firstly, but can potentially benefit the quality of care delivered by the organisation. There have been a range of problems associated with inpatient mental health nurses' engagement in CS and in experiencing the benefits of CS. This is concerning for the delivery of high quality care and the recruitment and retention of inpatient mental health nurses. What this paper adds to existing knowledge This paper explores and identifies factors influencing adequate and effective CS for inpatient mental health nurses' personal and professional development. It identifies 6 themes incorporating enablers and barriers for inpatient mental health nurses' CS which lead to practice recommendations for improvement. What are the implications for practice This paper advocates a needs analysis to improve access to CS for inpatient mental health nurses. This review specifically adds further knowledge relating to inpatient mental health nurses' engagement with CS which the application of the needs analysis could influence. Abstract IntroductionClinical supervision (CS) has been recognized as a reflective mechanism in inpatient mental health nursing practice; however, it remains unclear what adequate and effective supervision entails for inpatient mental health nurses. AimTo explore factors which influence adequate and effective clinical supervision for inpatient mental health nurses' personal and professional development. MethodWhittemore and Knafl's model for ensuring rigour was utilized. This included stages to address problem identification, literature searching, data evaluation, data analysis and presentation. Seven electronic databases were searched with hand searching/Internet searching. Fourteen retrieved articles were selected and appraised using the Mixed Method Appraisal Tool (MMAT). The data extracted from the papers were analysed thematically. ResultsThe review synthesis resulted in identifying six themes: (a) what makes CS effective; (b) reflection; (c) the facilitation of professional identity and knowledge through CS; (d) participation; (e) knowledge and understanding of CS; and (f) the facilitation of personal awareness and coping. DiscussionThis review adds further knowledge on the identification of effective CS for inpatient mental health nurses as a defined occupational healthcare group. Implications for practiceA suggested needs analysis is presented to improve access to CS options with the aim of promoting effective CS and increased engagement.

Emotional and psychological abuse are components of what are now more commonly accepted as aspects of domestic violence in addition to physical assault. Narcissistic abuse formulations of domestic violence are lesser known concepts and not recognised in UK health care in general, nor commonly in UK mental health services and by default mental health nursing. The effects on the individual who has experienced narcissistic abuse can be fatal or extremely debilitating, long lasting and individual recovery can be a complex process. This article will argue that the language and formulation of narcissistic abuse should be at the forefront of the multidisciplinary team's, and in particular mental health nurses' knowledge in order that victims can be directly supported or signposted to support to enable timely interventions and in-depth understanding.

Narcissistic abuse is a hidden form of abuse and remains under-recognized in society and within the helping professions, partly due to victim difficulties in articulating the manipulative behaviors they have experienced. Though research focusing on narcissism is extensive, there is a distinct lack of research into the abusive behaviors individuals with severe narcissistic traits use against others and subsequent victim experiences. With the aim of raising awareness of this form of abuse, the following evocative account utilizes autoethnographic memory work and portrays personal experiences of narcissistic abuse—specifically, gaslighting behavior, pathological dishonesty, and intimate abuse. The autoethnographic methods of this article are aligned with social justice and feminist epistemologies. Suppositions are offered to the reader centered upon trauma, loss, and healing in the context of the author’s personal experiences and inherent values as a mental health nurse and educator. Key reflections regarding the use of memory as method along with procedural, relational, and ethical considerations determine how the autoethnography and its portrayal may have been shaped.