A review of the existing literature shows that although numerous factors influence the quality of care, only a few have been thoroughly investigated as potential mediators impacting mental health professionals' perceptions of quality in psychiatric inpatient care. This study aimed to explore how burnout mediates the relationship between individual characteristics, ward environment conditions and professionals' perceptions of the quality of psychiatric care patients receive. A total of 117 professionals from two Norwegian health trusts participated in the study. Data were collected through an online questionnaire comprising validated instruments measuring quality of care, job satisfaction, perceived stress and burnout while collecting background information on sociodemographic and work-related factors. The relationships between these variables were analyzed using univariate and multiple regression analyses. The results showed that professionals who were open for developing quality work, found their work stimulating, had sufficient time for tasks and were satisfied with their job reported lower levels of burnout. In turn, burnout was associated with lower perceived quality of participation and secure environment. Overall, professionals generally rated the quality of care as high. These findings provide insights for designing interventions to improve workplace conditions, reduce risk of burnout and enhance the quality in psychiatric inpatients settings.

Mental health literacy of primary healthcare nurses is necessary to maintain a mentally healthy community. A lack of proficiency in identifying mental health disorders can lead to delays in accessing treatment. Not recognising mental health disorders is indicative of low mental health literacy. This quantitative study examined recognising mental health disorders as an aspect of mental health literacy among primary healthcare nurses. A Mental Health Literacy (MHL) questionnaire comprising five vignettes was administered to primary healthcare nurses working in three sub-districts of the Dr Ruth Segomotsi Mompati (RSM) District in South Africa. A total of 84 completed questionnaires were collected. Primary healthcare nurses most accurately identified depression (73.81%), followed by anxiety disorders (69.05%), suicidal thoughts (66.67%), schizophrenia (59.52%), and PTSD (41.67%). The results showed that most primary healthcare nurses were able to accurately recognise mental health disorders, achieving above-average recognition rates, except for PTSD. Given the critical role that early recognition plays in facilitating timely intervention, treatment, and improved quality of life, all primary healthcare nurses must possess strong mental health literacy skills. Targeted training in mental health literacy and practical application improves patient outcomes, strengthening community mental health and overall mental well-being.

This paper explores compassion and connection through a biophilic lens, examining how human-animal relationships reflect the moral and cultural foundations of nursing. Drawing on Edward O. Wilson's biophilia hypothesis, it considers examples from animal-assisted care with ducks in Tennessee and urban animal interaction spaces in Japan. Across these diverse settings, engagement with animals fostered emotional well-being, reduced anxiety, and reawakened empathy. The analysis situates biophilia within nursing's ethical commitment to compassionate care, proposing that intentional human-animal connection offers a universal pathway to empathy, healing, and quality of life across cultural contexts.

Dramatic increases in adolescent social media use have occurred alongside worsening adolescent mental and behavioral health and associated risk factors, including adverse childhood experiences (ACEs). Understanding these relationships is important for mental health nurses working with adversity-impacted adolescents. This study examined the association between ACEs exposure and problematic social media use (PSMU), and the moderating role of emotional and behavioral dysregulation among a diverse sample of young United States' (US) adolescents (10-14 years old). A secondary analysis using mixed-effects linear modeling was used to analyze adolescent and parent self-report data collected from baseline through 3-year follow-up in the Adolescent Brain Cognitive Development Study (ABCD Study). After adjusting for socio-demographic covariates, a significant positive association was found between adolescent cumulative ACEs score at 10-12 years and higher PSMU at 12-14 years: relative to adolescents with low (< 2) ACEs, those with high () ACEs reported higher PSMU (β = 1.5,  < 0.001). Adolescent emotional and behavioral dysregulation did not moderate this association. Findings underscore the importance of ACEs and mental health screening, as well as trauma-informed, developmentally appropriate preventative interventions to promote healthy social media use and reduce risk for PSMU among adversity-impacted adolescents.

Loneliness is a multifaceted phenomenon linked to adverse mental and physical health outcomes, increasingly understood as a relationally embedded experience shaped by sociocultural, cognitive, and emotional factors. While previous research has predominantly relied on surveys and clinical tools, emerging approaches recognize the value of unsolicited narratives shared on digital platforms. This snapshot study examines 498 Reddit posts from the subforums r/lonely and r/offmychest, using a publicly available annotated dataset to examine perceived causes and intensities of loneliness. Each post was annotated for types of loneliness cause and rated for intensity on a five-point scale. Descriptive statistics characterized the annotated dataset, and inferential analyses examined relationships among labels within this sample. Lack of friends emerged as the most frequently identified cause, whereas lack of family contact was associated with the highest perceived intensity. Co-occurring deficits across relational domains were common, particularly between lack of friends and lack of social support. Differences by subreddit and annotation batch were observed descriptively but were not statistically significant. These findings underscore the contextual, multi-causal nature of loneliness and support the value of Reddit as a site for accessing emotionally rich, real-time disclosures. Implications for mental health nursing include allocating space within assessments to explore relational complexity, drawing on patients' digital narratives when they emerge.

Psychiatric inpatient care is often characterized by brief admissions and an orientation toward acute treatments. Persons with dissociative identity disorder have been recognized as a vulnerable group within psychiatric inpatient care and are at risk of not receiving correct support in psychiatric inpatient care. Research within the area is limited and includes no overview of how persons with dissociative identity disorder are cared for in psychiatric inpatient care.

Empirical understanding of the effects of mindfulness-based interventions for post-traumatic stress disorder (PTSD) across different racial groups remains limited. This secondary analysis of a randomised controlled trial examined racial differences in trauma-related outcomes among U.S. frontline nurses traumatised by the COVID-19 pandemic. Participants ( = 56) were randomly assigned to either the MABSA intervention (Mindfulness and Acceptance-Based Smartphone App), a mindfulness app grounded in Acceptance and Commitment Therapy, or a wait-list control group. Outcomes included PTSD symptoms, experiential avoidance, rumination, mindfulness, and resilience. The intervention significantly reduced PTSD symptoms, experiential avoidance, and rumination for both Black and White participants compared to controls. A significant interaction effect was found for experiential avoidance, with Black participants showing greater improvement than their White counterparts. Across groups and time points, Black participants also consistently reported higher levels of rumination and mindfulness. These findings suggest that there may be differences in how individuals from different racial groups respond to mindfulness-based interventions, highlighting the importance of developing culturally informed PTSD treatments.

The beginning of poor physical health trajectory for young people with early psychosis is found to occur prior to the onset of psychosis. Promotion of physical health requires sustainable positive health behaviour change. This study is aimed at exploring the views of carers on the physical health of young people with early psychosis, the physical health care young people receive and carers' perspectives on important elements in promoting sustainable positive lifestyle changes. The outcome of this study will help inform the development of a co-designed lifestyle intervention for young people with early psychosis. Semi-structured interviews were conducted with 12 carers using an exploratory descriptive approach. Three main themes were identified using thematic analysis: (i) Physical health - what makes them worry and seek help; (ii) Disconnected physical health care; (iii) Key to sustainability - "Nothing succeeds like success". Carers are at the forefront of physical health promotion for young people. The findings of this study emphasised that a lifestyle intervention designed for young people should be tailored to the needs and preferences of not only young people but also their carers, with incorporation of elements of health literacy, psychosocial wellbeing and self-determination in the drive for sustainable positive health behaviour change.

Caring for women in compulsory psychiatric inpatient care entails having to make a number of different moral considerations. Using coercive measures leads to difficulties in creating a caring relationship and the care given to the women thus needs to be as ethical as possible. The aim was to describe healthcare staff's experiences of caring for women in compulsory psychiatric inpatient care. Eleven healthcare staff were interviewed, and the material was analyzed with a Reflective Lifeworld Research approach. The results show that healthcare staff move between self-examination and examining their colleagues closely and are also careful about protecting the women's privacy. An emotional rollercoaster is set in motion when the women's life situation affects the healthcare staff. Bridges are built, both with the next of kin but also with other authorities. It can be challenging to include the next of kin in the care for women in compulsory care since they may have a different view to that of the healthcare staff. Providing the healthcare staff with professional support and a supportive care environment may enhance their ability to provide a personalized care for the women in compulsory care.

In nursing practice, suicide risk is often encountered not only as a crisis of safety, but as a crisis of identity. Individuals facing suicidal despair frequently present with a fractured sense of self, belonging, and future direction - dimensions that are easily overlooked by symptom-based assessments. This article introduces the Character-Setting-Script (CSS) framework, a narrative identity model tailored for nursing and mental health care. Drawing from existential theory and narrative psychology, the CSS model maps suicide risk across three clinical domains: Character (who the person believes they are), Setting (where they come from and what cultural worlds shape them), and Script (what future they can still imagine). Designed to enhance therapeutic engagement and cultural responsiveness, this approach supports nurses in identifying early signs of narrative collapse and facilitating story-based interventions. By helping individuals re-author meaning, coherence, and possibility, the CSS model reframes suicide prevention as a relational, narrative, and deeply human act of care.

Cardiovascular conditions are the leading cause of pregnancy-related death among African American women (AAW). Stress is a risk factor for cardiovascular conditions that negatively impacts maternal health; however, research on stress management interventions for pregnant AAW is currently limited. Thus, we conducted a scoping review to explore the state of the science on this topic to better understand what types of methods, measures, and components have been utilized in stress management interventions for pregnant AAW. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis Extension for Scoping Reviews (PRISMA-ScR) framework was used to conduct a systematic literature search. Eight studies using quantitative ( = 4), qualitative ( = 2), and mixed methods ( = 2) were identified. Common intervention components were education, social support, mind-body exercises, and reflection. Studies additionally measured physiological stress, anxiety, and depression. Results for stress reduction were mixed; while two studies reported post-intervention decreases in stress, others found no significant changes, highlighting the preliminary nature of existing evidence. The qualitative studies provided information on intervention benefits and barriers to participation. Future intervention studies that are community-based, culturally-relevant, and target contextualized stressors are necessary to build confirmatory evidence on methods of stress management for pregnant AAW.

This issue has been identified as a public health problem, yet there have been few studies on the mental health and quality of life of nursing students in France. This research had two objectives: to examine the prevalence of psychological disorders (perceived stress, anxiety and depressive disorders) and to evaluate their quality of life. This cross-sectional study employed a descriptive observational design and included a sample of 1,866 nursing students. Socio-demographic and health history data were collected. Perceived stress, anxiety, depressive symptoms and quality of life were assessed using the PSS-14, HADS and WHOQOL-Bref scales. The data underwent descriptive and comparative analysis by gender and education, and correlational analysis. The findings revealed that 63.5% of nursing students had high level perceived stress, 50% had anxiety symptoms, and 14.4% had depressive symptoms. There were gender differences in perceived mental health, perceived stress and anxiety symptoms. There were also differences based on years of education in perceived physical health, anxiety symptoms and depressive symptoms. A negative link was found between the PSS, HAD-A and HAD-D, and WHOQOL. It can be concluded that future interventions to promote the mental health of nursing students should be implemented.

Suicide remains a leading cause of death among adolescents in the United States, and instances of death by suicide continue to increase in this population. To mitigate this public health crisis, effective and accessible suicide prevention programming is critical; however, suicide prevention programming is often developed and implemented without input from the adolescents engaged in the training. This study developed themes that emerged from student feedback as to how a school-based suicide prevention training, delivered to adolescents by either their peers or school personnel, could be improved. Data was collected from 2,480 adolescents who completed pre-training and post-training surveys between March 2022 and June 2023. Thematic analysis was used to explore participant responses to an open-ended question included in the post-training survey, which asked whether students had suggestions for improving the training. Four themes were generated: empowerment, self-care, increased sensitivity and discretion, and enhanced interactive learning and engagement. These themes highlight the need to incorporate a flexible, trauma-informed approach into school-based suicide prevention training. Given their role and expertise, nurses are well-suited to implement these strategies. Student perspectives should consistently be sought and integrated into curricula as communities strive to decrease death by suicide among adolescents.

Asian Americans and immigrants (AAIs) faced unprecedented challenges during the pandemic due to anti-Asian racist acts fueled by COVID19 rhetoric and the resulting racial trauma. This study explored AAIs' perceptions of these anti-Asian acts and their impact on psychosocial and mental health in the state of New Mexico (NM). Meyer's Minority Stress Theory provided the conceptual framework for the study. Sixty AAIs were conveniently recruited through various social networks in NM. Semi-structured interviews were conducted remotely, primarily in English. All interviews were transcribed verbatim. Thematic content analysis was used to identify codes, categories, and patterns across the transcripts. Most participants viewed anti-Asian racism as an inseparable part of their lives, describing direct or vicarious experiences of racism as surreal and emotionally torturous. Many reported feelings trapped in a "rabbit hole," alienated from mainstream society, and on the verge of emotional eruption. AAIs employed both unhealthy and healthy coping strategies for survival. The findings highlight the profound, life-altering distress-defined as suffering that disrupts the ability to cope with daily life-experienced by NM AAIs, underscoring the urgent need for long-lasting, tailored resilience programs (e.g. culture-specific counseling) to support their psychosocial and emotional well-being and foster a renewed sense of community-belonging.

This paper explores competing meanings which may arise through receiving a diagnosis of "borderline personality disorder," discussing how this may impact a person's treatment and their sense of self. This paper is informed by qualitative case study research, which utilized interviews to explore experiences of crisis and crisis intervention for people diagnosed with borderline personality disorder, their family and friends, and professionals who work with them. Utilizing this qualitative research data, alongside wider literature, the conceptualization of "borderline personality disorder" and the actual and potential real-world consequences of receiving this label are explored. Potential meanings are mapped onto a "black hole" model where potential competing meanings exist in the same place at the same time, and harm a persons sense of self. "Borderline personality disorder" is the most controversial personality disorder diagnosis. People may conceptualize their distress through four different labels for borderline personality disorder, be seen as "not real mental illness," "borderline of what?", not personality disorder, only personality disorder, and too unstable for therapy. Spaghettification, a term from astrophysics, is used as a metaphor to explain how a persons sense of self can fragment as they are pulled into the confusion of this black hole.

Individuals living with mental disorders are at heightened risk of lifestyle-related health problems and premature mortality. Lifestyle programmes with both individual support and group interactions with a person-centred focus in outpatient psychiatric care may help mitigate these risks. However, mental health staff's experiences of implementing such programmes remain underexplored. The aim of this study was to explore the experiences of mental health staff in facilitating a person-centred lifestyle programme within psychiatric outpatient care. Using a descriptive qualitative design, 10 mental health staff educated to group leaders were interviewed in semi-structured formats following their delivery of a 12-session lifestyle programme. Data were analysed using qualitative content analysis. Three main categories emerged: , and . Subcategories addressed challenges, such as lack of preparation time, organisational barriers, and the need for programme adaptation. The findings suggest that aligning lifestyle programmes with person-centred care emphasising both empathy and structure can enhance participants' health while fostering professional fulfilment among staff. To ensure long-term sustainability, enhanced organisational support and integration into routine practice are recommended.

Mental health disorders are prevalent and often treated with psychotropic drugs; however, concerns remain regarding their efficacy and long-term benefits. Likewise, there has been increasing attention on limiting psychotropic drug use to the minimum necessary level. Several studies have focused on deprescribing, often supported by various non-pharmacological interventions (NPIs). This study aimed to explore recent literature on the use of NPIs to support psychotropic drug deprescribing in adults.

The stepped care model aims to dynamically align the intensity of care with the patients' needs, adjusting mental health interventions accordingly. While stepped up care for mental illness has been widely researched, there is limited evidence on how stepped down care supports recovery after acute mental illness. This JBI qualitative systematic review sought to understand stakeholders' perspectives of stepped care in supporting patients' transitions from acute mental healthcare to community settings. CINAHL, Medline, Embase, PsycINFO and Web of Science were searched, and data were synthesized using the JBI meta-aggregation method. Fourteen studies were included. Themes were patient preference, emotional support, information and education, coordination, access to care, family and friends, continuity and transition, physical comfort, service delivery, health sector, and community setting. Patients expressed the importance of autonomy, with many stakeholders making assumptions about their care. Challenges with existing stepped care programs, include a lack of resources, strained patient relationships with providers, a lack of standardized care, and limited communication. Enhancing the design and delivery of stepped care following acute mental illness could support mental health recovery.

Suicide risk is often reflective and nonverbal, transmitted through the affective field of the clinician-patient relationship. This discussion paper advances a defense-informed framework showing how splitting, projection, and denial may be enacted interpersonally and registered as countertransference-guilt, detachment, or affective "whiplash"-that signals unspoken suicidal disintegration. Integrating psychodynamic and intersubjective theory with emerging suicidology (e.g. Suicide Crisis Syndrome), the approach formalizes countertransference as clinical attunement rather than interference. It augments standardized assessment by adding relational and embodied data, particularly when communication is fragmented, symbolic, or defended. Practice implications include routine affect check-ins, reflective supervision, and deliberate use of relational cues in formulation and safety planning. Although examples derive from youth and high-acuity services, the framework is transdiagnostic and portable across inpatient, community, and emergency settings. The aim is a more responsive, person-centered model of suicide prevention grounded in containment, co-regulation, and therapeutic presence.

This study examined the effect of a self-compassion-oriented mindfulness-based psychoeducation program on internalized stigma in individuals diagnosed with schizophrenia. This single-blind, randomized controlled experimental study was conducted with individuals with schizophrenia who were receiving follow-up care at a Community Mental Health Center in a province in northern Türkiye between June and August 2024. Following the administration of pretest assessments, the sample was randomly allocated into an experimental group ( = 21) and a control group ( = 21) through simple randomization. The psychoeducation program, adapted to the specific needs of this population, was administered to the experimental group. Data were collected using the Internalized Stigma of Mental Illness (ISMI) scale and the Descriptive Characteristics Form. Posttest measurements revealed a statistically significant difference between the experimental and control groups in the total score and the subdimensions of Alienation, Stereotype Endorsement, Perceived Discrimination, and Social Withdrawal ( < 0.05). However, no significant difference was observed between the groups in the Stigma Resistance subdimension scores ( > 0.05). The psychoeducation program significantly reduced the total scores on the ISMI among individuals diagnosed with schizophrenia, demonstrating a large effect size of 17.3% (η2 = 0.173;  = 0.006). These findings suggest that a self-compassion-oriented mindfulness-based psychoeducation program, adapted specifically for individuals with schizophrenia, is an effective intervention for reducing internalized stigma in this population.

We aimed to explore the effect of cognitive behavior intervention on violent behavior in female patients with schizophrenia (SP). A total of 86 female SP patients who were treated in Fuyang Third People's Hospital from January 2021 to January 2023 were included, and they were randomly divided into control and cognitive behavior intervention groups ( = 43). Patients in the control group received routine psychiatric nursing measures, including basic nursing, drug guidance, safety management, and psychological nursing. Those in the cognitive behavior intervention group received cognitive behavioral intervention based on routine nursing measures, including evaluating the condition and establishing a treatment alliance in the first week, knowledge training in the second week, cognitive reconstruction in the third week, and cognitive behavior training in the fourth week. The number of violent incidents after intervention was compared between the two groups. The Brief Psychiatric Rating Scale (BPRS) was used to compare the nursing effects. The incidence of violent behavior after nursing in the cognitive behavior intervention group was 13.9% (6/43), which was lower than that in the control group (39.5%, 17/43). There was no significant difference in BPRS between the two groups before nursing intervention ( > 0.05). After intervention, BPRS was notably decreased in the two groups than before intervention ( < 0.05), and the BPRS factor scores in the cognitive behavior intervention group were significantly lower than those in the control group ( < 0.05). This study provides preliminary evidence that CBI may reduce the incidence of violent behaviors in female patients with schizophrenia, with the intervention group demonstrating a lower rate of violent incidents compared to the control group. While these findings suggest the potential clinical utility of CBI for managing violence risk in this population, several important limitations must be acknowledged, including the restricted sample size and the exclusion of male patients.

Global migration has heightened due to various factors ranging from economic instability, political tension in many countries, escape from human rights abuse, search for better education and quality of life, as well as other involuntary reasons. Immigrants, irrespective of their immigration status, are often confronted by various challenges such as systemic inequities, identity conflict, community fragmentation, cultural and sociopolitical marginalization, including acculturation stress in their host countries that undermine their mental health. Current sociopolitical situations, particularly in the United States, further exacerbate these stressors. In light of this, mental health nurses must provide care that transcends borders, race, sexuality, or immigration status. Drawing on existing evidence, practice-based gaps, and emerging frameworks of culturally attuned care positions presence-centered care as a critical care approach in mental health care for vulnerable populations. There is transformative power in caring presence practice, particularly for immigrants who are confronted with various cultural and sociocultural stressors that exacerbate mental health issues among the population, inviting new discourse in this care dimension. Additionally, culturally attuned and presence-centered care are approaches that are culturally congruent to better prepare mental health nurses in the delivery of holistic care for improved mental health and overall well-being of the immigrant population.

Limited lesbian, gay, bisexual, transgender, and queer (LGBTQ) health research exists in many countries, including Thailand. Understanding LGBTQ outness is a key determinant in developing targeted and impactful mental health strategies. Outness among LGBTQ individuals, once safe from potential discrimination, brings significant benefits of acceptance, affirmation, and adequate healthcare access. This study examined outness patterns among 388 Thai LGBTQ adults, using a secondary analysis of a larger cross-sectional descriptive survey on minority stressors and mental health. The Outness Inventory measured identity disclosure and responses to those disclosures in three categories: the World, Family, and Religious Community. Descriptive and bivariate analyses were conducted. Participants reported higher levels of outness to the world Acceptance rates following LGBTQ disclosure were highest in the 'World' category, followed by 'Family' and then 'Religious Communities.' Percentage acceptance ranged from 30.15% for members of religious communities to 64.69% for their heterosexual friends. Overall, less acceptance among family members and religious communities was associated with participants being gay, feminine, and at an older age when first disclosing their LGBTQ identity. Outness has important implications for LGBTQ mental health nursing research. Interventions to support the coming-out process and promote positive attitudes toward LGBTQ individuals are most needed for their families and religious institutions.