Introduction In compulsory psychiatric care and forensic psychiatric care, supportive functions with independent roles have been instituted to uphold patient rights, preserve self-determination and personal integrity, work toward recovery and fulfill the obligation to ensure that individuals remain at the center of decision making. In Sweden, independent support persons (ISP) provide personal support and companionship to patients during and shortly after involuntary care. Knowledge about the ISPs experiences of the role is needed to expand and further develop the ISP role. This study aimed to illuminate ISPs experiences of their role regarding patients treated in compulsory psychiatric care and forensic psychiatric care. Methods The study used a qualitative design with semi structured interviews and inductive qualitative content analysis. Nine ISPs participated. Results ISPs experiences were reflected in the main theme Managing boundaries in a borderland, interpreted through the themes Balancing personal and professional approaches, Serving as social support and Being in the hands of staff. Discussion Findings highlights the important role of ISPs in mental health recovery through supportive, friendship-like relationships that promote reciprocity. ISPs help bridge social gaps, especially for those lacking networks. However, misunderstandings about their role can limit their impact.

Background

Although anorexia nervosa has been the focus of numerous studies, most research has been conducted within specialized eating disorder services, where the primary emphasis is on food, weight and physical markers of illness. The condition is described as difficult to treat, with persons with anorexia nervosa portrayed as being dominated by the illness and hard to engage in care. Treatment approaches are often rigid and protocol-driven, particularly in inpatient settings, where the primary aim is to preserve life. Given the limited research on psychiatric inpatient care for anorexia nervosa in settings not specialized in eating disorder treatment this qualitative study aims to explore lived experiences of being treated for anorexia nervosa in the context of general psychiatric inpatient care.

Methods

The study was conducted in Sweden between August and September 2023. Eighteen women participated. Seventeen submitted written narrative texts reflecting on their experiences, nine of whom also took part in individual interviews. Only one participant agreed to being interviewed only. Data were analysed using inductive qualitative content analysis, involving a systematic abstraction and interpretation of the textual content.

Results

Findings revealed one main theme, Being kept alive—but not being supported to live; three themes, Being invisible as a person; Being chained by hopelessness; and Aiming to get on the road towards recovery; and eight subthemes, Lacking existential support; Having to stand up for myself; Being disconnected from real life; Being restricted; Being marked for life; Needing human connection; Finding ways to live; and Finding meaning and hope.

Conclusion

The findings show that persons with anorexia nervosa may experience general psychiatric inpatient care as both life-saving and unsupportive. This calls for trauma-informed, recovery-oriented care that treats lived experience as essential expertise. Future work should focus on strategies to challenge entrenched assumptions in general psychiatric inpatient care and promote approaches that respect the complexity, autonomy, and meaning making of persons living with AN.

Introduction: For Kenya, prevalence estimates for pre- or postnatal depression range from 9 to 35%, with a wide spectrum of associated risk factors, spanning from unmet basic survival needs to social vulnerabilities. In the last three years, several cases of infanticide have received national attention. Whilst lack of material resources and social support may have contributed to each case, these factors alone may not fully explain the outcomes. To date, no study has examined maternal mental health in Kajiado County.

Aim: To explore mental health problems, social needs, and associated risk factors in women pre- and postnatally in Kajiado County in Kenya from the perspectives of women and health care workers (HCW).

Method: We conducted focus group-based interviews with pre- and postnatal mothers and HCW in Kajiado County. To ensure variation of experiences, five demographically and geographically diverse health care facilities were selected. Data was analysed using qualitative content analysis. The study followed the Standards for Reporting Qualitative Research (SRQR) checklist.

Results: Of all individuals approached, 49 (71.0%) women and 39 (61.9%) HCW agreed to participate and completed the interviews. The qualitative analysis identified three main themes: Autonomy and self-determination; Responsive maternal and mental health care; Community knowledge and acceptance of mental health problems. Women’s autonomy and self-determination were constrained by restricted reproductive choice, early and forced marriage, lack of control of material resources, social isolation, and gender-based violence. Maternal and mental health care were hampered by access barriers, fear of traumatic birth for women,and resource constraints, and emotional distress among HCWs. Community knowledge and acceptance of mental health problems were limited by stigma, spiritual beliefs, and misconceptions.

Conclusions: Our findings suggest that maternal mental health is closely intertwined with gender norms and prevailing perceptions of mental health problems. While expanding mental health services is necessary, it is unlikely to be sufficient on its own. Sustainable change will require promoting women’s rights, enhancing mental health literacy at the community level, and actively involving men. Besides, fear of traumatic birth must be addressed not only at individual but also at community level to break the cycle between uninformed maternal decision making and poor birth outcomes. In a next step, we will conduct a quantitative survey informed by these findings, with the results used to formulate and test a pragmatic intervention.

Aim To identify key aspects of recovery-oriented practice in caring for people with mental ill-health in general emergency departments.

Design A modified Delphi study with three rounds.

Methods A 24-member expert panel was recruited consisting of people with lived experience of mental ill-health, registered nurses working in emergency care, registered nurses specialised in psychiatric and mental health nursing and mental health recovery researchers. In the initial round, important aspects of recovery-oriented practice were identified through focus group interviews. Thematic analysis generated statements that were then reformulated as a questionnaire for subsequent rounds. The experts rated each statement's perceived importance on a 5-point Likert scale. The consensus level was set at ≥ 80%. Descriptive statistics were used to analyse the data.

Results Consensus was reached on the importance of 39 of 73 statements, with ≥ 80% deemed ‘very important’ in recovery-oriented practice in general emergency departments. Conclusion The study emphasises the delicate balance between the essential elements of recovery-oriented practice, their practical feasibility and the predominant biomedical perspective in general emergency department care. It proposes strategies to empower nursing staff and managers to adopt recovery-oriented practices that enhance the quality of care for people with mental ill-health. Enabling staff by providing the necessary prerequisites and a care environment that supports reflective practices is crucial. The responsibility for facilitating these changes needs to be a shared commitment between nursing staff and managers. 

Objectives: Persons diagnosed with anorexia nervosa (AN) may receive care in general psychiatric inpatient care (GPIC) for several reasons including severity of their condition, comorbidities and lack of access to specialised inpatient care. However, scant research has explored how this specific setting may impact persons with AN, either positively or negatively. Additionally, there is limited evidence regarding the most effective form of care for AN within GPIC. This integrative literature review provides a comprehensive overview of research focusing on care for AN in GPIC settings, shedding light on person-centred care and power within this specific context.

Design: The review was conducted according to the methods of Whittemore and Knafl. We searched the academic databases PubMed, CINAHL and PsycInfo, with the latest search conducted in March 2025, in accordance with a specific search strategy and analysed the data using a constant comparison method. The review is reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist for systematic reviews.

Results: The synthesis revealed three perspectives of care for persons with AN in the context of GPIC: management of the symptoms, treatment of the patient and support for the person. Overall, the findings suggest that GPIC can aid in weight gain, but the impact on recovery is unclear.

Conclusion: Research indicates that GPIC possesses the biomedical knowledge necessary to save lives, but there is a lack of research focusing on the perspectives of persons with AN. This gap in understanding may affect treatment outcomes, the possibility of recovery and the personal experience of care for those with AN in this context.

Introduction: Psychiatric inpatient care is often characterized by brief admissions and an orientation toward acute treatments. Persons with dissociative identity disorder have been recognized as a vulnerable group within psychiatric inpatient care and are at risk of not receiving correct support in psychiatric inpatient care. Research within the area is limited and includes no overview of how persons with dissociative identity disorder are cared for in psychiatric inpatient care. Aim: The aim was to map the area of knowledge on psychiatric inpatient care for persons with dissociative identity disorder. Method: This scoping review followed the Preferred Reporting Items for Systematic Review and Meta-Analysis for Scoping Reviews. The search strategy included both peer reviewed papers indexed in PubMed, Cinahl and PsycINFO, and grey literature. Results and conclusions: The review identified eight studies, revealing a small base of knowledge on psychiatric inpatient care for persons with dissociative identity disorder, showing the importance of further research exploring the significance of trauma awareness in this area. Further research should include persons with lived experience, both as participants and as partners in the research process. Nurses are in a position to prevent retraumatisation and promote person-centered approaches to care by valuing the patients’ perspectives.

In Sweden, a lack of accessible specialist mental health services places the sole responsibility for caring for people with mental ill-health in rural areas on primary care. Caring for people with severe mental ill-health can pose challenges for district nurses in rural areas. The aim of this study is to describe district nurse’s experiences of encountering people with mental ill-health in rural primary care. Semi-structured interviews were conducted with nine district nurses working in primary care in rural areas in Northern Sweden. Interviews were analyzed with qualitative content analysis. The results describe district nurses’ experiences of encountering people with mental ill-health as a strive for a good relationship. They wanted to understand the core of patients’ needs and adjust their approach based on that. However, organizational obstacles and opportunities affected these encounters, particularly the lack of time and the importance of continuity. Being a primary care nurse in a rural setting provides specific challenges and opportunities when caring for people with mental ill health. District nurses would benefit from organizational support in establishing and maintaining good relationships as a foundation for quality care. Providing district nurses with greater autonomy over their time, along with enhanced support and access to resources would acknowledge and reinforce the critical professional role they play in rural healthcare delivery.

Severe dissociative states involving the experience of being in parts, typically associated with diagnosis such as dissociative identity disorder and other specified dissociative disorders, continue to be a controversial and rarely studied area of research. However, because persons with severe dissociative states are at risk of being harmed instead of helped within psychiatric care, their experiences of living with such states warrant further examination, while innovative ways to include them in research remain necessary. Against that background, this study aimed to illuminate the meanings of living with severe dissociative states involving the experience of being in parts. This is a phenomenological hermeneutic study with data collected from three social media sources, one personal blog and two Instagram accounts, in February and March 2023. The results were illuminated in light of four themes; Striving to remain in the world, Balancing exposure and trust, Balancing belonging and loneliness and Owning oneselves. The interpretation of the themes suggests that living with severe dissociative states means being a human under inhuman conditions, striving for coherence and meaning in a world that is often unsupportive. This calls for a trauma-informed care to better support recovery for persons with severe dissociative states.

Background This article provides an update of the Reflective Practice Questionnaire (RPQ). The original RPQ consisted of 40-items with 10-sub-scales. In this article, the RPQ is streamlined into a 10-item single reflective practice construct, and a 30-item extended version that includes additional sub-scales of confidence, uncertainty/stress, and work satisfaction.

Methods A total of 501 university students filled out an online questionnaire that contained the original Reflective Practice Questionnaire, and two general measures of reflection: The Self-Reflection and Insight Scale, and the Rumination-Reflection Questionnaire.

Results Based on factor analysis, the RPQ was streamlined into a brief 10-item version, and an extended 30-item version. Small positive correlations were found between the RPQ reflective practice measure and the two measures of general reflection, providing discriminant validity evidence for the RPQ. The RPQ was found to be sensitive to differences among industries, whereas the general measures of reflection were not. Average reflective practice scores were higher for health and education industries compared to retail and food/accommodation industries.