Does shame mediate the influence of trauma on psychosis? A systematic review and meta-analytic structural equation modelling approach.

Background: Meta-analytic evidence has linked shame separately to both potentially traumatic events (PTEs) and psychosis, but the influence of shame on the relationship between PTEs and psychosis has not yet been examined. This study used meta-analytic structural equation modelling (MASEM) to examine whether shame plays a mediatory role between PTEs and experiences of psychosis.

Methods: A nested search was conducted within a previous systematic review on psychosis and shame to identify articles that contained a measure of PTEs.

The Early Infancy of a Parent and Baby Mental Health Unit: A Reflection.

Purpose: This article describes the experience of establishing a new parent and baby mental health unit, including challenges in the first year of operation. The article aims to narrate the experience for the purpose of informing other new mental health services and contributing to service development knowledge.

Description: The analogy of the early infancy period is used to highlight the parallel process of adjustment, confidence and identity formation occurring as part of the unit development and by the parents who are admitted.

Should Mother Baby Units be renamed Parent Baby Units? A critical reflection on gendered language in perinatal psychiatry.

Objective: Mother Baby Units provide mental health care to parents experiencing severe perinatal mental illness. The majority of admitted parents identify as mothers and are the birthing parent and primary caregiver for their infants. However, there is increasing recognition of transgender and gender diverse people who birth and parent infants, as well as awareness of the mental health needs of fathers, people in same-sex relationships, and other non-birthing parents.

Consumers Accessing Their Mobile Phone in an Acute Inpatient Mental Health Unit: Experiences of Consumers and Staff.

Mobile phones are an essential means for remaining connected, yet many acute inpatient mental health units restrict consumer access to their mobile phones due to safety concerns. The ubiquitous nature of mobile phones makes this approach seemingly incongruent with contemporary mental health practice. One Local Health District in Australia evaluated the implementation of a process that provided mental health consumers access to their mobile phones while in hospital.

'Profound personal and professional impacts': A qualitative study of clinician experiences of a mental health disaster response to Australia's black summer bushfires.

Objective: To explore the experiences of clinician and management stakeholders involved in a rural/metropolitan collaborative mental health disaster response to the 2019-2020 Black Summer bushfires in the Snowy Valleys region of southern New South Wales (NSW), Australia.

Setting: A mental health and drug health service in the Snowy Valleys region of rural NSW in collaboration with a mental health service from metropolitan Sydney, NSW.

Participants: Mental health clinicians and managers from a rural health district (n = 6) and a metropolitan health district (n = 8) involved in a collaborative disaster response to the 2019-2020 Black Summer bushfire disaster in the Snowy Valleys region of southern NSW, Australia.

Re-imagining the vulnerability and risk framing of parents with mental illness and their children.

To elicit compassion and communicate urgency to policy makers and governments, researchers and program developers have promoted a narrative of vulnerability and risk to frame the experience of families when parents have been diagnosed with mental illness. Developed within a western medicalised socio-cultural context, this frame has provided a focus on the need for prevention and early intervention in service responses while also unintentionally 'othering' these families and individualizing the 'problem'. This frame has had some unintended consequences of seeing these families through a deficit-saturated lens that misses strengths and separates family members' outcomes from each other.

Trauma in the lives of parents experiencing severe perinatal mental illness.

Background: The perinatal period is a time of 'high risk' for new and recurrent episodes of mental illness with 0.1-0.2% of birthing parents requiring admission to specialist mental health units in the months after birth.

Birth trauma in a population requiring inpatient mental health care in the postpartum period.

Objective: This study explores rates of birth-related symptoms of trauma in a population of parents experiencing severe perinatal mental illness.

Method: Birthing-parents admitted to a perinatal inpatient unit completed birth trauma measures on admission which were descriptively analyzed.

Results: The population had higher rates of birth-related potentially traumatic events and trauma-related symptoms than the general population.

An audit and analysis of electro convulsive therapy patient information sheets used in local health districts in New South Wales Australia.

Electroconvulsive Therapy (ECT) is a widely used psychiatric treatment; however, it remains contentious. It is therefore important that people are provided with accurate and balanced information before consenting to ECT. The aim of this study was to audit and analyse the content and language of ECT information sheets used in local health districts (LHDs) across the state of New South Wales Australia.

Trauma and the perinatal period: A review of the theory and practice of trauma-sensitive interactions for nurses and midwives.

Aim: With high rates of trauma in the population, known links between trauma and perinatal distress, and the intimate and close nature of the nursing and midwifery roles, ensuring awareness and understandings of trauma is crucial for guiding practice. This paper aims to explore the relationship of trauma to the perinatal period, based on theory and practice, to consider on how nurses and midwives can deliver trauma-sensitive interactions.

Design And Methods: This discursive discussion draws on relevant research from the fields of trauma therapy, attachment theory and nursing and midwifery practice to consider elements of trauma-sensitive practice in the perinatal period.

Vicarious trauma and nursing: An integrative review.

Nursing requires empathic engagement, within therapeutic relationships, to ensure the delivery of compassionate care. Empathic engagement with people who have experienced trauma is known to potentially lead to experiences of vicarious trauma occurring in the caregiver. However, relatively little is known about the implications of vicarious trauma for nurses.

Editorial Perspective: Prato Research Collaborative for change in parent and child mental health - principles and recommendations for working with children and parents living with parental mental illness.

Children whose parents have mental illnesses are among the most vulnerable in our communities. There is however, much that can be done to prevent or mitigate the impact of a parent's illness on children. Notwithstanding the availability of several evidence-based interventions, efforts to support these children have been limited by a lack of adequate support structures.

Trauma-informed qualitative research: Some methodological and practical considerations.

Mental health nurses who engage in research are likely to undertake research on sensitive topics, related to experiences of illness, care delivery and treatment. With recognition of the high prevalence of trauma in the lives of people who interact with mental health services, it is likely that many research participants will have experienced trauma in their lives and that while this may not be the focus of the research, sensitivity and awareness are required. Reference to 'trauma-informed' approaches in research design and practice is emerging in fields such as trauma-focused research and social sciences; however, it has not yet been applied to nurses.

Is trauma informed care possible in the current public mental health system?

Objectives: As mental health services move towards implementing 'Trauma-informed care', there is a need to consider the challenges posed within services and systems. This paper raises some of the challenges associated with integrating TIC into the current public mental health system. .

Towards epistemic justice doing: Examining the experiences and shifts in knowledge of lived experience researchers over the course of a mental health research training programme.

Participation of people with lived experience (LE) in mental health research is vital for improving the quality and relevance of research priorities, outcomes, and knowledge translation. Inclusion of people with LE is also recognized as central for achieving health service reform including commitments to human rights, social, and epistemic justice. Although a lack of research training is cited as a barrier to LE participation, few studies have examined the value of training for, or the specific requirements of, people with LE.

The 'trauma' of trauma-informed care.

Objectives: As mental health services increasingly position themselves as providing 'trauma-informed care', there is a need for ongoing critical reflection on the challenges that this movement highlights for mental health services, including those related to the concept of trauma itself.

Conclusions: To become trauma-informed requires opportunities to reflect on what trauma means and consideration of the challenges the concept poses to diagnostically driven systems. Alongside uptake, further debate is required.

Bridging the gap: A new integrated early intervention service for young people with complex mental health issues.

Aim: Two integrated headspace Early Intervention Teams (hEITs) were established in 2017 to bridge gaps between headspace, the national primary care youth mental health programme in Australia, and the state funded secondary and tertiary mental health services. This study aims to describe functioning and outcomes of patients referred to hEIT over a 6-month period.

Methods: A retrospective file audit was conducted for all patients accepted into the service over a 6-month period in 2018.

Clinician stakeholder experiences of a new youth mental health model in Australia: A qualitative study.

Aim: Late teens and early adulthood is the peak age of onset for mental disorders. Currently, there is a gap between primary mental health care and more intensive mental health services for young people in New South Wales (NSW), Australia. Two headspace Early Intervention Teams (hEITs) were developed to bridge this gap in Sydney Local Health District (SLHD), in Sydney, Australia.

Involving Mental Health Consumers in Nursing Handover: A Qualitative Study of Consumer Perspectives.

A number of benefits have been identified for including consumers in nursing handover, such as improved safety and information exchange. In mental health settings these benefits may translate to improved nurse-consumer engagement and working towards the provision of recovery orientated practice. The process of including the consumer, whilst considered best practice, is not well established in mental health settings.

'What would a trauma-informed mental health service look like?' Perspectives of people who access services.

Trauma-informed care is an approach to the delivery of mental health care based on an awareness of the high prevalence of trauma in the lives of people accessing mental health services, the effects of trauma experiences and the potential for trauma or re-traumatization to occur in the context of care. Across Australia, inquiries and reports have increasingly indicated an urgent need for mental health services to become trauma-informed. However, how Australian mental health services should deliver trauma-informed care is not well documented.

What is needed for Trauma Informed Mental Health Services in Australia? Perspectives of clinicians and managers.

Trauma Informed Care is an approach to the delivery of mental health care that requires sensitivity to the prevalence and effects of trauma in the lives of people accessing services. While TIC is increasingly emphasized in mental health policy and frameworks in Australia, people working in mental health settings have reportedly struggled to translate the values and principles into their everyday practice. This qualitative study used an experience-based co-design methodology to explore the potential for implementation of Trauma Informed Care into mental health services in Australia.

A frog in boiling water? A qualitative analysis of psychiatrists' use of metaphor in relation to psychological trauma.

Objective: Tensions about the definition, diagnostics, and role of psychological trauma in psychiatry are long-standing. This study sought to explore what metaphor patterns in qualitative interviews may reveal about the beliefs of psychiatrists in relation to trauma.

Method: A qualitative inquiry using systematic metaphor analysis of 13 in-depth interviews with Australian psychiatrists.

Intergenerational Trauma and Its Relationship to Mental Health Care: A Qualitative Inquiry.

Intergenerational trauma is a discrete form of trauma which occurs when traumatic effects are passed across generations without exposure to the original event. This qualitative study aimed to explore how psychiatrists understand intergenerational trauma in respect to their practice, for the purposes of identifying interventions for addressing intergenerational trauma in public mental health services. Findings revealed that psychiatrists observe intergenerational trauma frequently in their roles and try to opportunistically promote awareness of trauma with adults, and refer families to external services for supportive interventions.

Involving mental health consumers in nursing handover: A qualitative study of nursing views of the practice and its implementation.

Nursing handover occurs between shifts and is an important means of communication and information exchange around consumer care. The involvement of consumers in nursing handover, known as 'bedside handover', is well established within general health settings and promotes a patient-centred approach to care. Bedside handover represents an opportunity for mental health settings to consolidate recovery-oriented principles, albeit with some unique challenges in the way that involving consumers in nursing handover is implemented.

Does a community based recovery service reduce inpatient bed days?

Objective: Increasing options for the delivery of community-based care may be one way to reduce inpatient bed pressures. This study set out to examine the effect of community-based step up/step down (SUSD) care on hospital usage for service users with multi-service usage.

Methods: A retrospective audit was undertaken of the medical records of all individuals admitted to a SUSD unit over a 2-year period, calculating inpatient bed days for the 12 months prior to, and the 12 months after, the SUSD admission.