International Journal of Mental Health Nursing 

About: International Journal of Mental Health Nursing is an academic journal published by Wiley-Blackwell. The journal publishes majorly in the area(s): Mental health & Mental illness. It has an ISSN identifier of 1445-8330. Over the lifetime, 1719 publications have been published receiving 39302 citations.

Family violence and COVID-19: Increased vulnerability and reduced options for support.

Abstract: Family violence refers to threatening or other violent behaviour within families that may be physical, sexual, psychological, or economic, and can include child abuse and intimate partner violence (Peterman et al. 2020, van Gelder et al. 2020). Family violence during pandemics is associated with a range of factors including economic stress, disaster-related instability, increased exposure to exploitative relationships, and reduced options for support (Peterman et al. 2020). Due to the social isolation measures implemented across the globe to help reduce the spread of COVID-19, people living in volatile situations of family violence are restricted to their homes. Social isolation exacerbates personal and collective vulnerabilities while limiting accessible and familiar support options (van Gelder et al. 2020). In many countries, including Australia, we have already seen an increase in demand for domestic violence services and reports of increased risk for children not attending schools (Duncan, 2020); a pattern similar to previous episodes of social isolation associated with epidemics and pandemics (Boddy, Young & O'Leary 2020).

The COVID-19 pandemic and mental health impacts.

Abstract: The newly identified novel coronavirus, COVID-19, was first reported in Wuhan, China, in late 2019. The COVID-19 virus is now known to belong to the same family as SARS and Middle East respiratory syndrome coronavirus (MERS-CoV), which are zoonotic infections thought to have originated from snakes, bats, and pangolins at the Wuhan wet markets (Ji et al. 2020). The virus has rapidly spread across the globe leading to many infected people and multiple deaths (Wang et al. 2020); especially of the elderly and vulnerable (Centers for Disease Control and Prevention 2020). While efforts to control and limit the spread of the pandemic in the community are quite straight forward to follow, it seems that prejudice and fear have jeopardized the response efforts (Ren et al. 2020). In fact, the COVID-19 pandemic has already unleashed panic, as evidenced by the empty toilet paper shelves in stores, resulted in accusations against people of Asian races (Malta et al. 2020), and impacted people’s decisions to seek help when early symptoms arise (Ren et al. 2020). In this editorial, we discuss the issues related to the occurrence of fear, panic, and discrimination, analyse the causes of these phenomena, and identify practical solutions for addressing mental health issues related to this pandemic for both public and healthcare professionals. People tend to feel anxious and unsafe when the environment changes. In the case of infectious disease outbreaks, when the cause or progression of the disease and outcomes are unclear, rumours grow and closeminded attitudes eventuate (Ren et al. 2020). We know that the level of anxiety rose significantly when the SARS outbreak occurred. For example, in Hong Kong, about 70% of people expressed anxiety about getting SARS and people reported they believed they were more likely to contract SARS than the common cold (Cheng & Cheung 2005). Anxiety and fear related to infection can lead to acts of discrimination. People from Wuhan were targeted and blamed for the COVID-19 outbreak by other Chinese people and Chinese people have since been stigmatized internationally, for example, use of the term ‘China virus’ and the use of terms such as ‘Wuhan virus’ and the ‘New Yellow Peril’ by the media (Ren et al. 2020). Fear is a known (for centuries and in response to previous infectious outbreaks such as the plague), yet common response to infectious outbreaks and people react in many and individualized ways towards the perceived threat. Hypervigilance, for example, can arise because of fear and anxiety and, in severe cases, result in post-traumatic stress disorder (PTSD) and/or depression (Perrin et al. 2009). Fear of the unknown, in this case, the spread of the disease and the impact on people, health, hospitals, and economies, for example, raises anxiety in healthy individuals as well as those with pre-existing mental health conditions (Rubin & Wessely 2020). Individuals, families, and communities experience feelings of hopelessness, despair, grief, bereavement, and a profound loss of purpose because of pandemics (Levin 2019). Feelings of loss of control drive fear and uncertainty as the trajectory of the pandemics is constantly evolving; so is the advice on the action to take to stop the spread of a pandemic. Perceived mixed messaging from government or health officials can also lead to public confusion, uncertainty, and fear (Han, Zikmund-Fisher et al. 2018). People’s responses to fear and intolerance of uncertainty lead to negative societal behaviours (Rubin & Wessely 2020). Uncertainty increases feelings of alarm resulting in behaviours targeted at reducing uncontrollable situations which people fear. For example, we have seen people clearing shelves of supermarkets resulting in global shortages of food and essentials such as toilet paper (El-Terk 2020). This behaviour is purported to occur for two reasons: one because the threat of COVID-19 is perceived as a ‘real’ threat and expected to last for some time and second as a means to regain control (El-Terk 2020). While outright panic as a result of this pandemic is unlikely, it can occur as a consequence of mass quarantine (Rubin & Wessely 2020). The current state of the COVID-19 illness already paints a picture of inevitable and large-scale quarantine – some of which are already occurring. In the case of mass quarantine, experiencing social isolation and an inability to tolerate distress escalate anxiety and fear of being trapped and loss of control, and the spread of rumours (Rubin & Wessely

Trauma-informed care in inpatient mental health settings: a review of the literature.

Abstract: Trauma-informed care is an emerging value that is seen as fundamental to effective and contemporary mental health nursing practice. Trauma-informed care, like recovery, leaves mental health nurses struggling to translate these values into day-to-day nursing practice. Many are confused about what individual actions they can take to support these values. To date, the most clearly articulated policy to emerge from the trauma-informed care movement in Australia has been the agreement to reduce, and wherever possible, eliminate the use of seclusion and restraint. Confronted with the constant churn of admissions and readmissions of clients with challenging behaviours, and seemingly intractable mental illness, the elimination of seclusion and restraint is seen to be utopian by many mental health nurses in inpatient settings. Is trauma-informed care solely about eliminating seclusion and restraint, or are there other tangible practices nurses could utilize to effect better health outcomes for mental health clients, especially those with significant abuse histories? This article summarizes the findings from the literature from 2000-2011 in identifying those practices and clinical activities that have been implemented to effect trauma-informed care in inpatient mental health settings.

A Large-Scale Survey on Trauma, Burnout, and Posttraumatic Growth among Nurses during the COVID-19 Pandemic.

Abstract: A large-scale survey study was conducted to assess trauma, burnout, posttraumatic growth, and associated factors for nurses in the COVID-19 pandemic. The Trauma Screening Questionnaire, Maslach Burnout Inventory, and Posttraumatic Growth Inventory-Short Form were utilized. Factors associated with trauma, burnout, and posttraumatic growth were analysed using logistic and multiple regressions. In total, 12 596 completed the survey, and 52.3% worked in COVID-19 designated hospitals. At the survey's conclusion in April, 13.3% reported trauma (Trauma ≥ 6), there were moderate degrees of emotional exhaustion, and 4,949 (39.3%) experienced posttraumatic growth. Traumatic response and emotional exhaustion were greater among (i) women (odds ratio [OR]: 1.48, 95% CI 1.12-1.97 P = 0.006; emotional exhaustion OR: 1.30, 95% CI 1.09-1.54, P = 0.003), (ii) critical care units (OR: 1.20, 95% CI 1.06-1.35, P = 0.004; emotional exhaustion OR: 1.23, 95% CI 1.12-1.33, P < 0.001) (iii) COVID-19 designated hospital (OR: 1.24, 95% CI 1.11-1.38; P < 0.001; emotional exhaustion OR: 1.26, 95% CI 1.17-1.36; P < 0.001) and (iv) COVID-19-related departments (OR: 1.16, 95% CI 1.04-1.29, P = 0.006, emotional exhaustion only). To date, this is the first large-scale study to report the rates of trauma and burnout for nurses during the COVID-19 pandemic. The study indicates that nurses who identified as women, working in ICUs, COVID-19 designated hospitals, and departments involved with treating COVID-19 patients had higher scores in mental health outcomes. Future research can focus on the factors the study has identified that could lead to more effective prevention and treatment strategies for adverse health outcomes and better use of resources to promote positive outcomes.

“Take my hand, help me out:” Mental health service recipients’ experience of the therapeutic relationship

Abstract: The purpose of this study was to describe mental health service recipients' experience of the therapeutic relationship. The research question was 'what is therapeutic about the therapeutic relationship?' This study was a secondary analysis of qualitative interviews conducted with persons with mental illness as part of a study of the experience of being understood. This secondary analysis used data from 20 interviews with community-dwelling adults with mental illness, who were asked to talk about the experience of being understood by a health-care provider. Data were analysed using an existential phenomenological approach. Individuals experienced therapeutic relationships against a backdrop of challenges, including mental illness, domestic violence, substance abuse, and homeless- ness. They had therapeutic relationships with nurses (psychiatric/mental health nurses and dialysis nurses), physicians (psychiatrists and general practitioners), psychologists, social workers, and coun- sellors. Experiences of the therapeutic relationship were expressed in three figural themes, titled using participants' own words: 'relate to me', 'know me as a person', and 'get to the solution'. The ways in which these participants described therapeutic relationships challenge some long-held beliefs, such as the use of touch, self-disclosure, and blunt feedback. A therapeutic relationship for persons with mental illness requires in-depth personal knowledge, which is acquired only with time, understanding, and skill. Knowing the whole person, rather than knowing the person only as a service recipient, is key for practising nurses and nurse educators interested in enhancing the therapeutic potential of relationships.