Subjective well‐being of mental health nurses in the United Kingdom: Results of an online survey

The aim of the present study was to measure the subjective well‐being of a group of 225 UK registered mental health nurses (MHN) using three survey measures, and to identify whether certain demographic and workplace factors correlated with subjective well‐being measure scores. An online survey incorporating the subjective well‐being questions used by the Office for National Statistics, the Satisfaction with Life Scale, and the Warwick Edinburgh Mental Well‐Being Scale was administered to members of two professional bodies for MHN. There was good consistency between the three subjective well‐being measures, each demonstrating that UK MHN had a relatively low subjective well‐being. Apart from the Office for National Statistics question, ‘Overall, to what extent do you feel the things you do in your life are worthwhile?’, demographic and workplace factors did not correlate with subjective well‐being measure scores, although the characteristics of being male, living alone, and being aged 40–49 years were associated with lower mean scores on all three measures. The findings of the exploratory study suggest that a similar study should be undertaken with a larger representative population of MHN, and that qualitative research should explore why and how UK MHN have relatively low subjective well‐being. The limitations of this study, namely the response rate and sample representativeness, mean that the results of the present study must be tested in further research on the MHN population.     

Workplace resilience and emotional labour of Australian mental health nurses: Results of a national survey

Emotional labour is a form of adversity faced by mental health nurses in the context of their workplace interactions. Frequent exposure to emotional adversity can negatively impact mental health nurses’ biopsychosocial well‐being, workplace relationships, and performance. Workplace resilience is a dynamic interactive process within and between the person and their environment that promotes positive adaptation to adverse events and restores well‐being. Workplace resilience could be a protective process that helps mental health nurses positively adapt to workplace emotional adversity. This study aimed to investigate Australian mental health nurses’ workplace resilience and emotional labour and explore the relationship between them. A national cross‐sectional online survey comprising the Resilience at Work and Emotional Labour scales was completed by registered nurses (n = 482) working in a mental health role or setting across Australia. There was a strong negative relationship between resilience and the emotional labour strategy of surface acting. A positive association between resilience, frequency of emotional labour, and clinical supervision was also found. These findings point to a potential link between mental health nurses’ skills of cognitive reframing, and emotional and behavioural regulation needed to effectively manage their emotions and remain therapeutic in interpersonal interactions. Clinical supervision may be a key strategy in supporting mental health nurses’ resilience. Further investigation of workplace individuals’ internal and external resources, and organizational resources, supports, and strategies that can promote and strengthen mental health nurses’ well‐being is needed.     

The therapeutic effectiveness of creative activities on mental well-being: a systematic review of the literature

The aim of this paper was to investigate the literature to ascertain the effectiveness of creative activities on mental well-being within the mental health context. Creative activities have always been evident within the context of mental health and there is increasing recognition that the arts have an important role to play in improving the health and well-being of individuals. Medline, Cinahl and PsycINFO were searched utilizing the keywords art, therap, well-being and mental health. The arts council data base was accessed and the Department of Health review of Arts for Health Working Group. Eleven studies were appraised by one reviewer utilizing the Critical Appraisal Skills Programme tool. It was difficult to make comparisons of the papers accessed as a result of the majority of studies being evaluative in nature and untaken within local projects therefore lacking in generalization. The evidence suggests that creative activities can have a healing and protective effect on mental well-being. Their therapeutic effects promote relaxation, provide a means of self-expression, reduce blood pressure while boosting the immune system and reducing stress. However, the evidence to support these claims is weak and assumptions were made that lacked reliability and validity. Establishing the benefit of participating in creative arts is difficult because of a lack of consistency of a clear definition, but it is important to identify the potential of creative arts as a therapeutic and transformational tools and not an intervention for therapeutic diversion.     

The Schwartz Centre Rounds: Supporting mental health workers with the emotional impact of their work

In healthcare settings, there is an emotional cost to caring which can result in compassion fatigue, burnout, secondary trauma, and compromised patient care. Innovative workplace interventions such as the Schwartz Rounds offer a group reflective practice forum for clinical and non‐clinical professionals to reflect on the emotional aspects of working in health care. Whilst the Rounds are established in medical health practice, this study presents an evaluation of the Rounds offered to mental health services. The Rounds were piloted amongst 150 mental health professionals for 6 months and evaluated using a mixed‐methods approach with standardized evaluation forms completed after each Round and a focus group (n = 9) at one‐month follow‐up. This paper also offers a unique six‐year follow‐up of the evaluation of the Rounds. Rounds were rated as helpful, insightful, and relevant, and at six years follow‐up, Rounds were still rated as valuable and viewed as embedded. Focus groups indicated that Rounds were valued because of the opportunity to express emotions (in particular negative emotions towards patients that conflict with the professional care‐role), share experiences, and feel validated and supported by colleagues. The findings indicate that Schwartz Rounds offer a positive application in mental healthcare settings. The study supports the use of interventions which provide an ongoing forum in which to discuss emotions, develop emotional literacy, provide peer support and set an intention for becoming a more compassionate organization in which to work.     

Burning out physical and emotional fatigue: Evaluating the effects of a programme aimed at reducing burnout among mental health nurses

Burnout is a common problem among mental health nurses. High levels of burnout result in job dissatisfaction, rapid turnover of staff, physical and psychological discomfort, and a reduction in the quality of patient care. While there is an abundance of research relating to burnout per se, research regarding the impact of burnout prevention programmes is lacking. This study aimed to measure the effects of a burnout prevention programme on mental health nurses working in Saudi Arabia (SA). A quasi‐experimental design was used to test the effectiveness of a two‐day burnout prevention workshop. The sample consisted of an intervention group (n = 154) and a control group (n = 142). Data collected using the Maslach Burnout Inventory (MBI) measured the effects of the workshop at 1‐, 3‐, and 6‐month intervals after completion of the programme. Data were analysed using the latest version of SPSS. Means, standard deviations, frequencies, and percentages were used to describe the sample and levels of burnout. A t‐test, ANOVA, multiple linear regression, and chi‐squared were used to measure the effect of the workshop before and at the three time points after exposure. Findings indicate the programme was effective with a significant reduction being reported 1 month after the intervention. However, although not returning to baseline scores, burnout scores had increased at 6 months. In conclusion, while the overall efficacy of the burnout reduction programme is evident, mental health nurses would benefit from having opportunity to use some of the strategies on a regular basis.     

'They first killed his heart (then) he took his own life'. Part 1: a review of the context and literature on mental health issues for refugees and asylum seekers

This is the first in a two-part series of papers examining mental health issues for refugees and asylum seekers. Beginning with the suicide of an asylum seeker in Scotland, the paper emphasizes mental health issues for adult and child asylum seekers, stress and memory, suicide, self-harm, risk and protective factors, compulsory health treatments and the prevention of mental illness. It sets the scene for the second paper by drawing implications for nursing practice in the community. Although most literature on refugee and asylum seeker mental health exists outside of nursing scholarship, a majority of the issues reviewed in this paper are mutual challenges for all in the health and helping professions. Nurses interested in refugee and migration issues face two intertwined challenges: that of how to assist migrants with their diverse mental health needs and how, at the same time, to contribute to a society that can promote mental health for all by taking on both the difficulties and opportunities posed by cultural diversity.     

Outcomes of a co‐facilitation skills training programme for mental health service users,family members,and clinicians: the EOLAS project

Health policy is increasingly advocating for involvement of service users and family members in service development. In the present study, we evaluated the impact of a 4‐day education programme in co‐facilitation skills on clinician and peer (service users and family members) knowledge, confidence, and subsequent experience as co‐facilitators. The programme was designed to train peers and clinicians as co‐facilitators on a clinician and peer‐led information programme for people experiencing mental health problems. The study employed a mixed‐methods design involving a pre–post survey with 128 participants, and follow‐up qualitative interviews with a sample of 17 participants. To examine changes in levels of knowledge and confidence in facilitating from time 1 (T1) to time 2 (T2), paired sample t‐tests were conducted, and thematic analysis was conducted on the interviews. The programme had a statistically‐significant positive impact on participants’ knowledge, confidence, and skills, with no significant difference between the facilitator groups (i.e. service user, family member, and clinician) in terms of their improvement at the end of the training, indicating that all groups benefited equally from the training. A majority of participants reported a high level of preparedness as co‐facilitators and an open and respectful approach towards each other's expertise, and many continued to gain skills and develop their confidence as they co‐facilitated the 8‐week EOLAS programme (‘eolas’ is the Irish word for knowledge). The findings also provide evidence of the acceptability and feasibility of the programme, and appears to be the first detailed study reported on a programme of this nature.     

Effects of a music‐creation programme on the anxiety,self‐esteem,and quality of life of people with severe mental illness: A quasi‐experimental design

Many studies have shown that music therapy improves patients' symptoms. However, interventions using music creation as their core await further development for patients with severe mental illness (SMI). The current study investigated the effect of a music‐creation programme on the anxiety, self‐esteem, and quality of life of patients with SMI. A quasi‐experimental design using convenience sampling was adopted to recruit patients with SMI from a psychiatric day care centre. Participants were grouped based on their willingness to undergo an intervention (26 patients in the experimental group and 23 patients in the control group). The control groups participated in conventional mental rehabilitation therapy activities. The experimental group participated in a music‐creation session for 90 min every week over a 32‐week period. The outcome indicators before and after the intervention were assessed using the Hamilton Anxiety Rating Scale (HAM‐A), Rosenberg Self‐Esteem Scale (RSES), and World Health Organization Quality of Life‐BREF (WHOQOL‐BREF). Finally, the intervention effect was determined using generalized estimating equations (GEEs). After 32 weeks of intervention activities, the experimental group showed significant improvements in their HAM‐A total scores (P < 0.001) and RSES total scores (P = 0.005). Regarding quality of life, the improvements of the experimental group in terms of the psychological (P = 0.016) and social relationship domains (P = 0.033) were superior to those of the control group. Music‐creation programmes are recommended for inclusion in the routine rehabilitation activities of patients with SMI.