Experiences of People Who Self Harm in secure settings

This is the peer reviewed version of the following article: [Dake, A., Murphy, N., & McAndrew S. (2022). Self-harm in secure settings: Exploring the Lived Experiences of people who self-harm in secure hospitals. International Journal of Mental Health Nursing, vol(issue), pages], which has been published in final form at [https://doi.org/10.1111/inm.13092]. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions. This article may not be enhanced, enriched or otherwise transformed into a derivative work, without express permission from Wiley or by statutory rights under applicable legislation. Copyright notices must not be removed, obscured or modified. The article must be linked to Wiley’s version of record on Wiley Online Library and any embedding, framing or otherwise making available the article or pages thereof by third parties from platforms, services and websites other than Wiley Online Library must be prohibited.Globally, an increasing number of people who Self Harm (SH) are being treated in mental health hospitals. Incidences of SH are common in secure hospitals, with those using the behaviour being highly dependent on staff for care and support but impacting on often limited resources. Whilst literature related to the lived experiences of people who SH exists, this is in its infancy in African countries. The aim of this study was to explore the lived experiences of people who SH in two secure mental health hospitals in Ghana. Interpretive Phenomenological Analysis (IPA) was used to explore the experiences of people who SH in two secure mental hospitals in Ghana. A convenience sample of nine participants were recruited and face to face in-depth semi structured interviews were used to collect data. With the permission of each participant all interviews were audio recorded and notes were made by the researcher (first author). Each interview was transcribed and analysed using the IPA seven- step approach, with three superordinate and 11 subordinate themes being identified. The superordinate themes were: Being let down; Living with the negative self; Forces of the supernatural and religion. Findings demonstrate that there is a need to develop a collaborative health care package if appropriate care and support is to be offered to people in secure settings who use high-risk behaviours, such as SH. To ensure care is holistic, culturally, and temporally relevant research is needed, particularly in Sub-Saharan Africa

Experiences of People Who Self Harm in secure settings

This is the peer reviewed version of the following article: [Dake, A., Murphy, N., & McAndrew S. (2023). Self-harm in secure settings: Exploring the Lived Experiences of people who self-harm in secure hospitals. International Journal of Mental Health Nursing, 32(2), 534-543], which has been published in final form at [https://doi.org/10.1111/inm.13092]. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions. This article may not be enhanced, enriched or otherwise transformed into a derivative work, without express permission from Wiley or by statutory rights under applicable legislation. Copyright notices must not be removed, obscured or modified. The article must be linked to Wiley’s version of record on Wiley Online Library and any embedding, framing or otherwise making available the article or pages thereof by third parties from platforms, services and websites other than Wiley Online Library must be prohibited.Globally, an increasing number of people who Self Harm (SH) are being treated in mental health hospitals. Incidences of SH are common in secure hospitals, with those using the behaviour being highly dependent on staff for care and support but impacting on often limited resources. Whilst literature related to the lived experiences of people who SH exists, this is in its infancy in African countries. The aim of this study was to explore the lived experiences of people who SH in two secure mental health hospitals in Ghana. Interpretive Phenomenological Analysis (IPA) was used to explore the experiences of people who SH in two secure mental hospitals in Ghana. A convenience sample of nine participants were recruited and face to face in-depth semi structured interviews were used to collect data. With the permission of each participant all interviews were audio recorded and notes were made by the researcher (first author). Each interview was transcribed and analysed using the IPA seven- step approach, with three superordinate and 11 subordinate themes being identified. The superordinate themes were: Being let down; Living with the negative self; Forces of the supernatural and religion. Findings demonstrate that there is a need to develop a collaborative health care package if appropriate care and support is to be offered to people in secure settings who use high-risk behaviours, such as SH. To ensure care is holistic, culturally, and temporally relevant research is needed, particularly in Sub-Saharan Africa

Female Genital Mutilation Protection Orders

Globally, the exodus of individuals who have been forced to flee their home and seek refuge in countries of safety has led to a refugee crisis. The United Kingdom (UK) has engaged with the United Nations High Commissioner for Refugees (UNHCR) in playing a significant role in the long-term resettlement of refugees, half of whom are children and young people. One initiative of such humanitarian resettlement is the Gateway Protection Programme (GPP). To-date, there is a dearth of studies investigating aspects of acculturation that affect the mental health of young refugees resettled under the UNHCR humanitarian programme. This study aimed to explore aspects of acculturation that could enhance the mental health of GPP young refugees several years after resettlement. Using narrative research, a purposive sample of 31 GPP young refugees, who had a minimum of three years stay in the UK, were recruited from local Refugee Community Organisations. Data was collected through a multi-method design combining Focus Group Discussions (FGDs) with Visual Arts-Based Narrative Research (VABNR) and analysed thematically. Three overarching themes emerged: People and places; Its nearly all new to me; Finding self. This study contributes important knowledge regarding the mental wellbeing of young people who have engaged in a resettlement programme and offers valuable information for policy makers and mental health professionals working with GPP young refugees

The lived experiences of pastoral staff employed in social, emotional, and mental health (SEMH) secondary schools: a narrative exploration

This paper explores experiences of pastoral staff, working in social, emotional, and mental health (SEMH) special secondary schools, regarding the psychological impact of their work. To date, attention has been given to the educational experiences of pupils attending SEMH schools and teachers working with pupils with SEMH needs in mainstream schools. Whilst these studies provide insight into the experiences of pupils and teachers, they do not explore the experiences of those occupying pastoral roles in SEMH schools. Using narrative research, five participants, recruited from schools in the Northwest of England, took part in interviews, conducted via video conferencing. Interviews were audio recorded and transcribed verbatim. Analysis adopted a two-stage approach. The first stage focused on each individual narrative, preserving it as a whole story, the second involved analysis across the five narratives. Both stages used Fraser’s (2004) seven stage approach, enabling long sections of narrative to be broken down into themes, whilst preserving the nuances within and across narratives. The first stage of analysis identified numerous themes specific to each participant, the second stage, the focus for this paper, identified two common themes across the narratives: ‘It’s a struggle,’ ‘and ‘My emotionally dirty work’. This is the first study to explore the psychological impact of working in SEMH secondary schools, from the perspective of pastoral staff. Findings have policy and practice implications; defining professional standards, appropriate training, and tailored supervision. An ‘ethos of care’ within SEMH schools could mitigate against the impact of struggles and work perceived as emotionally dirty

Crossing borders: discussing the evidence relating to the mental health needs of women exposed to female genital mutilation.

The terms ‘Female Circumcision’ (FC), ‘FG Cutting’ (FGC) and ‘FG Mutilation’ (FGM) refer to procedures involving the partial or total removal of the external female genitalia fornon-medical reasons. In practicing countries, FGC/FC is more widely used, as it is believed to be inoffensive, providing more impartial ways of discussing the practice. Positive beliefs about FC/FGC include virginity, marriage prospects, family reputation, or passage to adulthood. Regardless of terminology, the practice exists in at least 28 African counties, and a few Asian and Middle Easterncountries. In Western society, FGM is considered a breach of human rights, being outlawed in a number of countries. With immigration trends, FGC is now prominent in Western society among practicing communities. While the past decade has seen an increase in studies and recommendations for health-care support related to the physical health consequences of FGM, little is known about the psychological impact and its management. For many girls and women, FGC is a traumatic practice,transforming it to FGM and affecting their mental health. This discussion paper focuses on evidence relating to the mental health consequences of FGM, therapeutic interventions, and the mental health nurse’s role in addressing the needs of this group of women

Support Our Sisters (SOS): A Female Genital Mutilation (FGM) Specialist Psychosocial Service in Salford, Greater Manchester: A pilot project. Narratives of women whose mental health has been affected by the COVID-19 pandemic.

Aim This research report outlines key findings from an exploratory study with women, living in the UK, who come from a Female Genital Mutilation (FGM) practicing community, on the psychosocial impact of COVID-19 on their mental health. Methodology A focus group discussion took place with seven women recruited from a specialist service for women at risk of, and/or affected by FGM, in Salford, a city located in the Northwest of England. The women were predominantly Muslim, aged between 25 years to 55 years, and were of Black-African and south-Asian heritage. Findings The focus group discussion was analysed using thematic analysis. Three major themes emerged: (1) Positive testing, negative interpretation, (2) COVID-19 Lockdowns, and (3) Lack of accurate information. Conclusions The study provided insight into the lived experiences of women living in the Northwest of England during the COVID-19 lockdown, in a community in which a high rate FGM is reported to occur. The study identified a range of issues that professionals should explore to better understand how to support the mental health needs of women affected by FGM during pandemics, such as the COVID-19 crisis, in a culturally competent way, without stigmatising their personal beliefs or local communities, and to avoid racial profiling of affected communities

An evaluation of Support Our Sisters (SOS) - A Female Genital Mutilation (FGM) Specialist Psychosocial Service piloted in Salford, Greater Manchester. Pilot Project Evaluation Report

This report details an evaluation of the Female Genital Mutilation (FGM) Support Our Sisters (SOS) Pilot Clinic in Salford, Greater Manchester. The SOS Clinic is hosted by the New Step for African Communities (NESTAC), a third sector organisation based in Greater Manchester, registered as a charity since 2003. NESTAC runs a wellbeing programme for people of Black, Asian, and Minority Ethnic heritage with a focus on women and young girls who are victims of harmful ‘traditional’ abuse, including FGM

The fabric of a career in mental health nursing from an Australian and UK perspective

As the prevalence of mental illness increases globally, Australia and the United Kingdom (UK) share concerns regarding the recruitment and retention of nurses to the field of mental health care. The level of preparedness of nurses is thought to have a bearing on recruitment and retention in mental health nursing practice. This study sought to uncover what Australian and UK undergraduate students perceived as motivational in choosing a career in, and being prepared for, working in mental health settings. METHOD This study employed mixed methods, using a questionnaire comprising of both quantitative and qualitative questions. Quantitative data was analysed using SPSS (V.16.0) and content analysis was undertaken for analysing the qualitative data. FINDINGS Following ethical approval, data was collected from, four universities in Australia and two in the UK. A total of 447 undergraduate nursing and midwifery students, who had completed a mental health placement, completed the questionnaire. Findings revealed that motivational factors influencing their interest in mental health nursing were clinical experience (49.7%), personal/life experiences (42.9%) and the role of the lecturer (23%). However, 47.7% of all participants had some previous experience of mental illness, with only 18.4% having had work experience in the field prior to starting their course. IMPLICATIONS This study adds to extant knowledge of what encourages people to choose a career trajectory in mental health nursing and what could be harnessed with regard to retention. The knowledge gained from these findings is useful in informing recruitment processes and can also inform curriculum

The Therapeutic Engagement Questionnaire (TEQ) : a service user-focused mental health nursing outcome metric

Abstract: Background: Therapeutic engagement (TE) has been described as the crux of mental health nursing but despite its perceived importance, to date, there is no measurement tool that captures it. As a result, there is no way of determining the contribution of mental health nursing interaction to service user recovery, in acute inpatient mental health settings or the wider care quality agenda. Methods: To develop and validate a TE measurement tool in partnership with Service Users (SUs) and Registered Mental Health Nurses (RMHNs). The TEQ was developed in 3 stages: 1) item generation (and pre-testing), 2) item reduction using Principal Component Analysis (PCA), and 3) validation across Mental Health Trusts in England. Results: The final questionnaire has two versions, (SU and RMHN version), each scored within two contexts (1–1 SU-RMHN interactions and overall environment and atmosphere of the ward) and includes 20 items with two sub-scales (care interactions and care delivery). Psychometric evaluation of the TEQ shows high inter-scale correlations (0.66–0.95 SU; 0.57–0.90 RMHN), sound sub-scale internal consistency (> 0.95), concurrent validity (> 0.60) and adequate score variability for both versions of the TEQ. In summary, the TEQ behaves well as a measurement tool. Conclusions: The TEQ can determine the collaborative and empathic nature of RMHN-SU interactions, capture if SUs are treated with dignity and respect and recognise that the principles of the recovery approach are being respected. The TEQ can also provide robust monitoring of nursing activity, offer opportunity for transparency of activity, feed into healthcare organizations’ key performance indicators and provide reassurance about the nature and quality of nurses’ work

Resettling into a new life: Exploring aspects of acculturation that could enhance the mental health of young refugees resettled under the humanitarian programme

Globally, the exodus of individuals who have been forced to flee their home and seek refuge in countries of safety has led to a refugee crisis. The United Kingdom (UK) has engaged with the United Nations High Commissioner for Refugees (UNHCR) in playing a significant role in the long‐term resettlement of refugees, half of whom are children and young people. One initiative of such humanitarian resettlement is the Gateway Protection Programme (GPP). To date, there is a dearth of studies investigating aspects of acculturation that affect the mental health of young refugees resettled under the UNHCR humanitarian programme. This study aimed to explore aspects of acculturation that could enhance the mental health of GPP young refugees several years after resettlement. Using narrative research, a purposive sample of 31 GPP young refugees, who had a minimum of three‐year stay in the UK, were recruited from local refugee community organizations. Data were collected through a multi‐method design combining focus group discussions (FGDs) with visual arts‐based narrative research (VABNR) and analysed thematically. Three overarching themes emerged: People and places; Its nearly all new to me; and Finding self. This study contributes important knowledge regarding the mental well‐being of young people who have engaged in a resettlement programme and offers valuable information for policymakers and mental health professionals working with GPP young refugees