Mental Illness and Psychiatry: The 20th and Early 21st Centuries

The aim of this paper is to present the opposing views and tensions that characterised the evolution of psychiatry and understandings of mental health during the 20th century and the early decades of the 21st century. To this extent, the principal figures and entities that occupied the main fronts during these debates are presented during a description of the journey undertaken by psychiatry during the aforementioned years. Quotes from various original texts or their translations have been included in an attempt to recreate the spirit of the periods under study. This historical exploration provides further insight into the multifaceted world of mental health, its illnesses, treatments and the role of a number of influencing bodies that were crucial into shaping this discipline across the centuries

The Therapeutic Alliance in Mental Health Services: A Politico-Critical Analysis of Knowledge and Power

The therapeutic alliance in mental health services has been researched extensively especially with regards to care provider and care receiver characteristics that may affect therapeutic outcomes. In the literature, it seems to be commonly assumed that the alliance has an inherent power imbalance in favour of the professional. Beyond this assumption, research on the knowledge-power balance in the alliance is limited. The aim of the study was to explore the dominant discourses related to the balance of knowledge and power in the therapeutic alliance in mental health services. An additional interest was the role that these identified discourses may play in the positions occupied by care providers and care receivers in the alliance. A final objective was the identification of care provider and care receiver knowledge needs in relation to the management of the knowledge-power balance in the alliance in a manner that may enhance therapeutic effects. Ten semi-structured interviews were conducted involving individuals who were receiving psychiatric care in the inpatient setting at the state psychiatric hospital in Malta. The second phase of this study involved the analysis of the Medical and Nursing records that pertained to the ten participants who had been interviewed. A Foucauldian Discourse Analysis framework was used to guide the study and Foucault’s concepts of knowledge and power served as the theoretical underpinning of the study. The care receivers’ contribution to the discourses pertaining to the knowledge-power balance in the alliance led to the identification of four different types of alliances with distinguishable knowledge-power characteristics. Three discursive themes were identified from the Medical and Nursing records and these were perceived as being complementary to the findings that emerged from the care receivers’ interviews. Finally information related to the potential knowledge required by care receivers and care providers in order to manage the knowledge-power balance in an effective manner was extracted from the data and presented together with recommendation

Nursing Students’ Perceptions of the Use of Physical Restraints in Acute Care Hospital Settings

Attempts to justify the traditional use of physical restraints have commonly centred on the need to enhance patient safety. However, issues have been progressively raised in terms of ethical considerations, human rights and the potentially harmful effects of restraints. In this view, many countries have attempted to move away from the routine use of physical restraint by incorporating alternative methods. Although several studies have explored the perceptions of patients and nurses regarding the practice of patient restraint, knowledge regarding student nurses’ perceptions is limited.  The aim of this multiple case study was to explore the perceptions of this observed practice among six nursing students in their final year of a four-year undergraduate nursing program. These students had observed (but not participated in) the application of physical restraint to patients in acute care settings. A thematic analysis of the participant interviews and corresponding focus group data revealed the following: the perception that physical restraints are better than chemical restraints; consideration of, and access to alternative and less invasive measures; the need for proper restraining equipment; and training for nursing students in the physical restraint of patients. Recommendations focus on the need for training in the use of physical restraint methods and propose alternative measures to physical restraints. &nbsp

Knowledge, Attitude, Preparedness and Behavior of Nurses Towards Intimate Partner Violence in Mental Health Settings

Various studies have explored healthcare professionals’ knowledge, attitudes and preparedness towards intimate partner violence (IPV). However, there is a dearth of research, which focuses on nurses working in mental health settings. This study explored the knowledge and preparedness of nurses working in mental health settings to identify and manage IPV. The hypothesis developed for this study was: nurses have negative perceptions towards the management of IPV; and demographic characteristics influence the nurses’ perceptions towards IPV. A cross-sectional quantitative survey design was used. One hundred and nine nurses working within the acute in-patient and community mental health setting completed the Physicians Readiness to Manage Intimate Partner Violence Survey (PREMIS). The results of the study show that the participants lack competence in identifying potential victimized individuals and may not feel adequately prepared and knowledgeable to address IPV in their practice. However, they are willing to manage IPV and have identified the need of more competence in the area. These findings are similar to literature which involved populations other than nurses who work in mental health settings. Nurses in mental health settings need training on how to identify and manage IPV cases. Mixed methods research in this area is also recommended

Beyond emotional trauma : a systematic review of military personnel’s perspective and impact

The purpose of this systematic review was to locate and evaluate pertinent literature that exam ined how military search and rescue personnel perceived emotional trauma, its repercussions, and the coping mechanisms they used to deal with its impacts. The Hydra Data Initiative platform was used to search for publications found in databases that are in the English language. This review followed the guidelines provided in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. The selection of both qualitative and quantitative research was based on key words as well as a variety of inclusion criteria. The quality assessment of the generated studies was facilitated by the use of the Critical Appraisal Tools Program. In total, 13 studies were included for evaluation. The articles that qualified for evaluation were both qualitative (n=2) and quantitative (n=11) in nature, examining the reported effects of exposure to traumatic experiences (n=8), the most common coping mechanisms used by first responders (n=3), and first responders’ individual experiences after experiencing emotional trauma (n=2). Few studies have been conducted on how military search and rescue personnel perceive and react to emotional stress. This was revealed through having to incorporate studies comprising other occupations, regarded as first responders. This analysis focuses on the many emotional trauma impacts and coping mechanisms used by search and rescue personnel to manage this upheaval. It is intended that this evaluation would provide fresh knowledge and give experts the tools they need to create reliable support systems.peer-reviewe

Post-Traumatic Growth after Cancer: A Thematic Analysis Study

Background: That a diagnosis of, and treatment to cancer brings along shock, distress and possible long-term negative life changes is very clear from human experience and research alike. But such an experience can also relate to positive life changes, as increasing research on the aftermath of serious illness, such as cancer diagnosis consistently shows. Observations of positive outcomes linked to quality of life are increasingly being found in cancer studies. These results seem to converge with post-traumatic growth (PTG)  which emphasize positive life changes as resulting from considerable life-changing events that are borne from crises or trauma. Objectives: Aims to this study were to 1) investigate the holistic impact and ramifications of PTG on the recovery from serious illness such as cancer; 2) clarify the relationship, if any, of PTG with mental health outcomes; and 3) how is PTG strengthened or otherwise, when one is faced by such life-changing event. Methods: Using a Thematic Analysis design, we investigated how the diagnosis of, and treatment to cancer impacted the patients and survivors. Semi-structured interviews were conducted with people who had received treatment for breast (n=3), MSS (n=1), ovarian (n=2), bone (n=2), H. Lymphoma (n=1), Liver (n=1). Using descriptive mapping, we clarified whether this study results are consistent with Tedeschi and Calhoun’s PTG framework. Results: Findings charted on the key factors of PTG. Conclusions: Cancer results in varied consequences and in negative and positive adjustments. Further development of findings which charted on major PTG dimensions is warranted

One direction

This paper draws on the data from the study commissioned by the Faculty for SocialWellbeing (University of Malta) in 2023 called ‘The perceived effect of traffic on our wellbeing amongst the Maltese Population’. It seeks to navigate around the seeming impact of traffic on the populace, in terms of social wellbeing. In this paper, we will be revealing that there are no two ways around this phenomenon. What we will be referring to asthe ‘trafficisation’ in our communities is having a major impact on our standard of living. In other words, the commodification of our communities, and car ownership as one of the indicators, is starting to leave an indelible mark on the livability and quality of life of its citizens. The liminality of progress and economic affluence in relation to our quality of life is the tension that will be debated in this epistemological-driven piece of work. The paper will attempt to confer the research question that livability and improved quality of life depend on re-negotiating a lifestyle which is not car centric.peer-reviewe

Mental wellbeing in Malta during the pandemic aftermath : a call-to-action

During the 2019 Coronavirus disease (COVID-19) pandemic, mental health challenges constituted a parallel peak to physical health difficulties. Local research conducted during COVID-19 identified mental wellbeing implications that merited consideration. Currently, the population is progressing to a new normality. Whilst the encouragement to adapt is commended, the mental wellbeing nuances experienced during COVID-19 pandemic and in the face of an altered reality following the pandemic, need to be addressed. This paper will navigate around some of the needed changes in the local context. This literature review utilised the University of Malta library resources and main online media portals to access literature involving the local context that is Malta, focusing on a specific mental wellbeing area rather than on generic mental health, and published between 2020 and 2022. Eligible publications yield it for four areas, namely loneliness, anger, social media access, and mental health at the workplace. These were explored with international literature to elicit further recommendations. The analysis yielded recommendations on environmental and architectural considerations, awareness and access to mental-health services, changes at the workplace, and consideration of identity markers to ensure accessibility to our social welfare systems to all.peer-reviewe

Mental Health Perceptions from Artwork

The relationship between artwork and mental health has been the subject of various research endeavours. Whilst artwork has been long used as a means of emotional expression, it is also a method of raising mental health awareness. In this study, an art collection was presented to depict the challenges faced by many individuals living with a mental illness. Through a series of open-ended questions, twenty-nine participants were requested to give a title to each piece and to describe the perceived message and emotions related to each painting. The thematic analysis process of the participants’ descriptions led to the identification of three themes, namely those of Darkness, Solitude and Recovery. Whilst congruence was often observed between the participants themselves and between the viewers and the artist, discrepancies were also noted. Artwork can be an important medium in addressing stigma and in guiding reflections on mental health topics

Developing community identity in a rapidly changing community

The significance of a sense of community is widely acknowledged in the literature. Communities bring their members networks of connections that can shape aspects of their behaviour, social interactions and identities. However, development and modernity are challenging the roles of communities, with weaker social bonds and less neighbourly behaviours on the rise. In a young community known for its terraced family homes, as well as its villa area, recent changes in construction permits are bringing rapid changes, not only to its aesthetics, but also to the density and nature of its residents. This paper, which is based upon a study of the community of Iklin, examined the impact that recent changes are having through the views of the residents via a questionnaire, interviews and a focus group. Using the Iklin study as a model for a mid-sized town or village in Malta, this paper examines which factors contribute to a sense of community cohesion and identity. This discussion posits that, like Iklin’s residents, when faced with an ever-changing community of inhabitants that do not feel like they belong, the inhabitants of our towns and villages, will value green spaces as amongst the most sought-after factors within communities, along with a desire for shared spaces and activities. A craving for a sense of community remains present, coexisting with an appreciation for a level of anonymity and distance that is also valued by many.peer-reviewe