North Korean refugee women face significant psychological, economic, social, and cultural challenges when adapting to South Korean society. Understanding these challenges is essential for developing effective nursing interventions and health policies to support their successful adaptation.

Depression and anxiety are among the most prevalent mental health disorders globally, often leading to significant impairments in daily functioning. While traditional treatments are practical, complementary approaches-such as nature-based and animal-assisted therapies-are gaining recognition. Home aquariums may offer a safe, accessible, and underexplored therapeutic modality for individuals experiencing these conditions.

Restrictive laws still impede nurse practitioners (NPs) from realizing the full scope of their training and education in too many states. While practice laws vary from state to state, working in states with restricted practice policies creates a multitude of barriers for patients seeking accessible, high-quality mental health care, especially in rural areas.

The psychiatric nursing field faces challenges in recruiting, training, and retaining educated nurses. A Work-Learning Program (WLP) within an academic-practice partnership may address these issues.

Chronic shortages of mental health providers restrict access for 51 million people in the United States with mental illness. Psychiatric-mental health nurse practitioners (PMHNPs) can help expand access using technology and team-based care.

ObjectivesThis paper describes the different modalities of Coordinated Specialty Care (CSC) in first-episode psychosis and illustrates how psychiatric nurse practitioners can fulfill important roles in the team-based effort of individualized treatment and therefore increase access to specialized care for those suffering from early serious mental illness.MethodsReview of published literature and other online resources on first-episode psychosis (FEP) and CSC, shortage of psychiatric providers, and the role of the Psychiatric Mental Health Nurse Practitioner.ResultsResults are extracted from published literature on young persons experiencing FEP within current CSC models, as well as other online resources evaluating the increasing psychiatrist shortage throughout the United States.ConclusionThis article explores the potential roles and benefits of integrating psychiatric nurse practitioners into first-episode care and advocates that their involvement improves access to timely and effective interventions for young persons experiencing new-onset psychosis.

Telehealth offers a flexible and effective alternative to in-person behavioral health services, with users generally reporting high satisfaction. However, several barriers can limit equitable access among Medicaid beneficiaries.

BackgroundThe Philippines is a significant supplier of nurses worldwide despite facing a considerable nursing shortage of about 127,000 in its healthcare system. Given the challenging socioeconomic conditions that can heighten their risk for various mental health issues in the country, it is crucial to explore the rate and factors of depression among Filipino nurses to support them in their roles better.AimsThis systematic review explores the rate and associated factors of depression among Filipino nurses.MethodsAfter screening and assessing 56 studies from three databases, data from three studies were extracted, described, compared, and synthesized.ResultsThe proportion of nurses who self-reported experiencing depressive symptoms among the eligible studies ranged from 19.5% to 45%, with 11.2% to 19.9% of participants indicating mild symptoms, 5.8% to 18.2% reporting moderate symptoms, and 2.5% to 6.8% reporting severe to extremely severe depressive symptoms. Depression rates were higher among nurses intending to migrate (31%) than those not intending to migrate (23%). Depression was positively associated with disengagement, exhaustion, and overall occupational burnout, while it was negatively associated with personal faith, spiritual contentment, and religious practice.ConclusionThese findings highlight the need for community-based and hospital-based mental wellness programs for nurses that enhance their motivation, engagement, self-efficacy, and spirituality. Future research should explore longitudinal studies and broader sampling methods to enhance generalizability. Research can also focus on interventions, such as the different religious and spiritual practices, as well as policies addressing depression and its implications.

BackgroundAdverse childhood experiences (ACEs) are associated with both increased depressive symptomatology and nicotine dependence (ND) in the general population. However, the relationship between ACEs, depressive symptoms, and ND among people with mental illness (MI) remains unexplored.AimsIn this study, we examined (a) depressive symptoms mediating the relationship between ACEs and ND and (b) ND severity mediating the relationship between ACEs and depressive symptoms.MethodA cross-sectional design was used to recruit participants online and from community mental health settings. Data analysis was conducted using IBM SPSS version 29.ResultsResponses from 194 individuals were included in the analysis. ND intensity mediated the relationship between ACEs and depressive symptom severity. The indirect variance of the effects of this mediation was 10.9%, 6.9%, and 10.6% among the total sample, females, and males, respectively. In addition, depressive symptoms mediated the relationship between ACEs and ND intensity, and the indirect variance of the effect of this mediation was 7.9%, 3.6%, and 8.8% in the total sample, females, and males, respectively.ConclusionsAmong people living with MI, ND mediates the impact of ACEs on depression, with varying degrees of influence between genders. In addition, depressive symptoms mediate the effect of ACEs on ND intensity. Further research is needed to investigate effective depressive treatment modalities to be integrated into tobacco treatment plans among people living with MI. In addition, nurse clinicians should assess for childhood adversity and depressive symptoms among tobacco users while treating ND.

The COVID-19 pandemic created challenges for nurses and healthcare systems, including mental health concerns and intention to leave job roles.

Serious mental illness (SMI) in pregnancy is a public health concern due to associated poor maternal-child outcomes. There is a gap in the literature about the healthcare experiences of pregnant women with SMI and the experiences of providers who care for this population. The purpose of this scoping review is to examine the current state of the science regarding the experiences of pregnant women with SMI and the experiences of providers when treating this population.

Health care workers are sustaining significant numbers of workplace violence events, and health care organizations are called to respond. Through critical evaluation, comprehensive planning, and thoughtful steps into action, organizational leaders and direct care staff must work collaboratively to meet the demands of the dynamic health care landscape. Our objective is to identify multidisciplinary, evidence-based practice strategies through the use of tools, innovation, and education to equip health care teams in building a culture of personal and organizational safety.

Workplace violence (WPV) in healthcare is detrimental to staff and institutions. The prevalence of events continues to increase despite efforts to mitigate events. WPV is associated with psychological and physical consequences and has been attributed to healthcare workers leaving the field, further contributing to the shortage of frontline healthcare staff. Healthcare workers often underreport WPV events due to cultures of acceptance, lack of knowledge of resources, and feeling unsupported during or after an event.

Violent behavior by patients on psychiatric units is a topic that has received considerable attention, particularly with regard to its consequences for nursing staff. While studies have sought to identify predictors of violence by inpatients, there is a dearth of research on dynamic risk factors, particularly anger.

This discussion paper elaborates the elements of patient engagement and teamwork that support the effective use of de-escalation during tense situations marked by increasing threat, lability, or hostility. Staff training often involves de-escalation techniques which equip staff with important basic skills. Yet what often fails to be explained during training are subtle elements operating on inpatient child/adolescent milieus that are critical to the effectiveness of this intervention.

Mental health intake may be a time of vulnerability for transgender and gender-expansive (T/G-E) people. Here, we describe processes that create a supportive environment where T/G-E people can feel welcome and safe.

To explore an innovative model for nursing administration practice in which a trauma-informed care approach is applied to staff and personnel management. This model is applicable especially for preventing workplace violence and managing its aftermath in psychiatric care facilities.

ObjectiveThis paper updates the psychiatric mental health (PMH) nursing community regarding the progress of five recommendations for policy and practice to enhance workplace violence (WPV) prevention. This information should be useful to nurses in their efforts to advocate for workplace safety.MethodsA comprehensive search of current literature, organizational action, and national policy relevant to the recommendations are reviewed and discussed to enhance WPV prevention and safety.ResultsWorkplace safety is a critical concern for PMH nurses and has far-reaching implications in PMH nursing settings. While there has been implementation of state policy around WPV, federal legislation remains stalled. The national accreditation standards continue to provide individual institutions guidance around WPV data collection, reporting, and analysis, but these data do not inform national efforts particularly around defining requirements for mechanisms to support healthcare workplace protection. However, recent research continues to document both prevalence and associated conditions/quality metrics. While dashboards are now available for public reporting of select WPV data, nationally the public reporting standards remain the same. Organizing a nursing voice in WPV reporting resulted in interesting exemplars. Thus far, no data are available on efforts to include safety in nursing curricula.ConclusionsThe safety of nurses, particularly PMH nurses, is a multi-faceted problem that will require efforts in regulatory, organizational, educational, and personal behavior change.

BackgroundIn the United States, it is estimated that 75% of healthcare workers report encountering workplace violence. Assaults on healthcare workers are associated with increased turnover rates, job dissatisfaction, trauma, and an inability to complete job tasks.AimsThe purpose of this quality improvement project was to evaluate the effectiveness of an education program to increase healthcare workers' knowledge and confidence in managing agitation and violence.MethodsThe project used a single group, pre- and post-test design to evaluate an educational intervention, a modified Awareness, Vigilance, Avoidance, Defense, and Escape/Environment (AVADE) program, using the Confidence in Coping with Patient Aggression Instrument (CCPAI), a 30-day post-intervention follow-up, and a post-violent incident follow-up. Quantitative data were analyzed using descriptive statistics and paired -tests, and qualitative data were analyzed using content analysis of an open-response question on the post-violence and 30-day follow-up surveys.ResultsThackery's CCPAI was completed by 130 participants, across 20 different departments, and 13 job titles. The modified AVADE program was found to increase confidence among healthcare workers when coping with patient aggression.ConclusionAn educational intervention emphasizing de-escalation techniques, situational awareness, self-defense, appropriate restraint use, legal considerations, and case studies increased healthcare workers' confidence in managing patient aggression. According to a 30-day follow-up survey, staff members applied at least one of the strategies taught during the course to handle violent incidents within a month of completing the training.

Actions of physical violence, harassment, or other threatening and intimidating behavior characterize workplace violence, often subsequently followed by seclusion to maintain safety in emergency department (ED) and psychiatric settings. Though there is no universally identified benchmark of acceptable rates of seclusion, April to September 2023 preintervention rate of seclusion hours on a psychiatric ED unit at a public state hospital in the southeast was 5.57/1,000 patient care hours, exceeding current comparison data from Centers for Medicare and Medicaid Services (CMS) for calendar year 2022 with a state average, 0.26/1,000 patient care hours and national average, 0.35/1,000 patient care hours.