The professional psychiatric/mental health nurse: skills, competencies and supports required to adopt recovery‐orientated policy in practice

Cusack, Eithne; Killoury, F.; Nugent, Linda

doi:10.1111/jpm.12347

Cited by 54 publications

(56 citation statements)

References 17 publications

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“…Thus, we see active ownership from the MHCP leaders as a necessary step in implementing the GSD to ensure that the GSD trainees prioritized and actually joined the planned supervision. Effective leadership and supervision are also emphasized by Cusack, Killoury, and Nugent () as important factors when implementing new practice. Further, they point towards a learning culture that value of training and education as central factors to facilitate new practice (Cusack et al, ).…”

Section: Discussionmentioning

confidence: 99%

The deadlock of saying “That is what we already do!” A thematic analysis of mental healthcare professionals’ reactions to using an evidence‐based intervention

Jørgensen

Christiansen

Nissen

et al. 2019

Psychiatric Ment Health Nurs

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Accessible Summary What is known on this subject? There is a need to shed light on healthcare professionals’ reactions to the use of the Guided Self‐Determination method in a mental health hospital to better understand and adjust the implementation process of evidence‐based practice. Healthcare professionals´ values and beliefs play an important role when implementing evidence‐based practice in real‐world healthcare settings. What this paper adds to existing knowledge? The study identifies opposite positions in mental healthcare professionals: being ready or resistant to change when implementing an evidence‐based intervention. The positions are elaborated in four thematic dynamic continuums describing reactions to using the intervention. In addition, this is the first study to explore mental healthcare professionals´ reactions to using the Guided Self‐Determination method in a mental health context. What are the implications for practice? When preparing implementation of an evidence‐based intervention, it is important to consider adaptation of the intervention, the mental healthcare professionals’ acceptability, support from management and participation in supervision. In future research, it is important to consider collecting data from mental healthcare professionals trained in using an evidence‐based intervention, however not using it in clinical practice, to understand barriers towards evidence‐based practice. Abstract IntroductionEvidence‐based interventions are required in mental health nursing to improve quality and outcome for patients. However, there is a need to shed light on professionals’ reactions to the use of evidence‐based interventions to better understand and adjust the implementation process. AimTo explore mental healthcare professionals´ reactions to using the evidence‐based intervention Guided Self‐Determination method in the care of inpatients with severe mental illness. MethodA qualitative study conducted in relation to an 8 months implementation program. Data collection: 9 qualitative interviews and field notes generated from supervision of the intervention. ResultsFour themes emerged from a thematic analysis: “The expert becomes novice,” “Theory used as a looking glass,” “Guided Self‐Determination perceived as an interruption” and “Becoming an informer of the impact of GSD.” DiscussionUsing the themes may help leaders or researchers predict or discover the support needed by individual professionals. Implications for practiceWhen preparing implementation of an evidence‐based intervention, it is important to consider adaptation and acceptability, as well as support from management and participation in supervision. Finally, it is worth to consider collecting data from trained professionals, who did not use the intervention in practice to understand barriers towards evidence‐based practise.

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Section: Discussionmentioning

confidence: 99%

The deadlock of saying “That is what we already do!” A thematic analysis of mental healthcare professionals’ reactions to using an evidence‐based intervention

Jørgensen

Christiansen

Nissen

et al. 2019

Psychiatric Ment Health Nurs

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“…As has been found in other studies, mental health nurses want to practice from within a Recovery model but at the same time are required to enforce hospital policy and other institutional requirements (Hornik‐Lurie et al, ). It also becomes difficult to practice Recovery model principles when the medical model of psychiatry is dominant (Crowe, ) and in being so, is inhibitive of Recovery‐oriented approaches (Cusack, Killoury, & Nugent, ). In all of this, a clear tension therefore exists between Recovery, which is person‐focused, and psychiatric medicine, which is illness‐focused (Buchanan‐Barker & Barker, ).…”

Section: Discussionmentioning

confidence: 99%

The governance of sexuality in a Recovery‐oriented mental health service: Psychosis, consumers and clinical approaches

Evans

Quinn²,

McKenna

2019

Psychiatric Ment Health Nurs

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Accessible summary What is known on the subject The intersection of sexuality and psychosis has a long history, yet research in this area has been minimal over the past few decades. Mental health clinicians practice from within the confines of a mental health system that is founded on a conflict between containment and care and that positions the consumer as an object of care. At the same time, mental health services often have a Recovery approach to care. This presents a difficulty and tension in mental health clinical work because the Recovery approach is opposed to positioning the consumer as an object. What this paper adds to existing knowledge The findings suggest that sexuality and sexual needs are common to both clinicians and consumers, and via identification, make the two groups more similar than different. Sexuality can problematize and so open up questions about the objectification of consumers. Consideration of consumers' sexuality and sexual needs can therefore work as a resistance to the dominant mental health approach and, in doing so, produce a more Recovery‐oriented approach to treatment in terms of how the consumer is positioned. Other aspects of living that escape capture by the diagnostic system may also operate as organizing factors for a more subject‐to‐subject approach to treatment. The implications for practice Focusing on sexuality and other aspects of living that escape capture by the diagnostic system can bring into question the way consumers are objectified by the psychiatric model of care. AbstractIntroductionThe Recovery approach introduced a radical shift in the positioning of consumers as subjects rather than objects of mental health treatment. While this approach has been internationally adopted, the practice of Recovery has been under‐researched and a knowledge gap exists regarding the intersection of sexuality and psychosis.AimThe study aim was to investigate how sexuality was governed in a long‐stay mental health rehabilitation facility that was Recovery‐oriented.MethodA case study methodology with a conceptual framework using Foucault's work on disciplinary power was used.ResultsThe findings illustrated how mental health clinicians were caught between two main and incompatible models of care: a psychiatric one and a Recovery one.DiscussionWhile the policy framework authorized a Recovery approach, clinicians practised surveillance, hierarchical observation and normalization, which are tenants of a psychiatric model of care. However, the study found that sexuality was an area that opened questions about the psychiatric model for clinicians. Consideration of consumers' sexual needs allowed the clinicians to think of consumers more as subjects like themselves than as objects to be treated.Implications for practiceConsideration of consumers' sexuality opens up possibilities for questioning the objectification of the consumer via the psychiatric model.

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“…Training for staff is also addressed [43], including for psychiatric nurses [44] or staff in housing facilities [45]. Some are thus about changing already practicing professionals' attitudes or that of patients [46,47], while others target specific categories of patients like veterans [48,49] or youth [50].…”

Section: Resultsmentioning

confidence: 99%

Recovery-oriented Medical Training: An Informational Rapid Literature Review for the University of Recovery as a New Concept of Co-learning between Patients and (Future) Healthcare Providers

Pelletier¹,

Tourette-Turgis²

2016

J Community Med Health Educ

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Recovery has undoubtedly gained traction throughout the world, and much effort is going into the transformation of mental health policies and systems to achieve recovery-oriented outcomes. There is also a growing argument that emphasizes the interconnectedness of mental and somatic health dimensions, with one dimension affecting the state of the other, and the recovery vision has thus also begun to influence chronic physical illness management. As mental and physical health integration may include colocation, by which the mental health specialist sees patients with various physical health conditions in the same primary care setting, it has been suggested that this colocation could also be conceptual and, in fact, favored by the sharing of a common and global recovery vision for a genuine holistic and person-centered approach. A rapid review of literature was performed to inform the development of a series of workshops to train psychiatry residents and medical students to recovery. Although a plethora of writings exists on ways to transform existing practices to make them more recovery-oriented, not much is known about training techniques meant to inculcate recovery values and principles within the initial training of doctors and other professionals. Through this review, we could not find any faculty of medicine-based class with official institutional credentials specifically and explicitly meant to train future professionals to recovery. The University of Recovery emerged as a new approach to training, not only on recovery, but more importantly for training in recovery. In effect, at the 'with-no-walls' University of Recovery, professors learn from students and conversely through a 'flipped classes' approach by which patients and (future) providers experiment with recovery together, for example, with inversed role plays and other small group techniques of co-learning, as discussed in this paper.

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The professional psychiatric/mental health nurse: skills, competencies and supports required to adopt recovery‐orientated policy in practice

Cited by 54 publications

References 17 publications

The deadlock of saying “That is what we already do!” A thematic analysis of mental healthcare professionals’ reactions to using an evidence‐based intervention

The deadlock of saying “That is what we already do!” A thematic analysis of mental healthcare professionals’ reactions to using an evidence‐based intervention

The governance of sexuality in a Recovery‐oriented mental health service: Psychosis, consumers and clinical approaches

Recovery-oriented Medical Training: An Informational Rapid Literature Review for the University of Recovery as a New Concept of Co-learning between Patients and (Future) Healthcare Providers

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