Major depression challenges the ways of living for both individuals and families. The aim of this study was to describe what happens and how to manage major depression in a family. The case in this paper is a family with a mother who is suffering major depression and her son and daughter. Narrative interviews and qualitative content analysis were conducted. The findings revealed six themes: "a stealthy intruder," "moving slowly to helplessness," "saving the situation," "protecting oneself and others," "conveying things that are beyond words," and the "dispersal of shadows." These themes elucidated the family members' varying views of depression and the unique ways they managed the situation.

The aim of this study was to explore how young (16-25 year old) informal carers of a person with a mental illness experience and use support. In a mixed method approach, we interviewed 12 young carers, and 241 completed a self-administered questionnaire. While the young carers strive to maintain control, their main support seems to be others in their lives, who often define the situation differently. The carers said web-support, counseling, and group counseling might be helpful, yet very few had any professional support. Young carers are greatly in need of support and it should be provided.

This study compared the caring situation, health, self-efficacy, and stress of young (16–25) informal carers (YICs) supporting a family member with mental illness with that of YICs supporting a friend. A sample of 225 carers, assigned to a family group (n = 97) or a friend group (n = 128) completed the questionnaire. It was found that the family group experiences a lower level of support and friends experienced a lower positive value of caring. No other differences in health, general self-efficacy and stress were found. YICs endure different social situations, which is why further study of the needs of YICs, especially those supporting friends, is urgently needed.

People with psychotic disorders experience to a great extent avoidable physical illnesses and early mortality. The aim of the study was to investigate the potential effects for this group of participating in a lifestyle intervention. A multi-component nurse-led lifestyle intervention using quasi-experimental design was performed. Changes in biomedical and clinical measurements, self-reported health, symptoms of illness and health behavior were investigated. Multilevel modeling was used to statistically test differences in changes over time. Statistically significant changes were found in physical activity, HbA1c and waist circumference. A lifestyle intervention for people with severe mental illness can be beneficial for increasing physical activity. © 2019 Blomqvist et al. Published with license by Taylor & Francis Group, LLC.

Life expectancy is greatly reduced in patients with schizophrenia, and cardiovascular diseases are a leading cause of mortality. The aim of this cross-sectional study was to investigate the prevalence of overweight, obesity, and cardiovascular disease (CVD) risk and to investigate the relationships between self-rated health, sense of coherence, CVD risk, and body mass index (BMI) among people with severe mental illness (SMI) in psychiatric outpatient settings. Nearly 50% of the participants were exposed to moderate/high risk of CVD and over 50% were obese. The results showed no statistically relationships between the subjective and objective measures (Bayes factor <1) of health. The integration of physical health into clinical psychiatric nursing practice is vital. © 2018 Taylor & Francis Group, LLC

People with psychotic disorders have a significantly increased risk of physical diseases and excessive mortality rates. The aim of the study was to investigate relationships between changes in physical activity, levels of salutogenic health, and glycated hemoglobin among people with psychotic disorders after participation in an individualized lifestyle intervention. The results from analyses showed that self-reported increased physical activity was positively associated with the level of salutogenic health and negatively associated with the level of HbA1c on an individual level. The results indicate that coordinated, individualized, holistic and health-promoting nursing care is crucial to enabling enhanced lifestyle within this vulnerable target group. © 2023 The Author(s). Published with license by Taylor & Francis Group, LLC.

The process of personal recovery among persons diagnosed with schizophrenia may be facilitated through innovative health promotion interventions targeting multidimensional aspects of subjective well-being. The current pilot study aims to test the use of self-rated questionnaires as a means of evaluation of the effects of an equine-assisted intervention for persons diagnosed with schizophrenia. Twenty adults diagnosed with schizophrenia were offered a 12-week EAT intervention performed six times once every 14 days by a licenced mental health nurse. Two validated self-rated questionnaires, HSCL-25 and SHIS were used as outcome measurements at baseline and at post-treatment, additionally the self-rated questionnaire PANAS was completed twice a week starting one week before the 12 week - EAT intervention. Only six of the twenty participants managed to complete the validated questionnaires. Despite the low response rate of approximately 30 %, a significant difference was found between pre and post scores for positive affect and well-being. Effect sizes, ranging from small to large for pre-to-post treatment scores indicated less depression and anxiety, more positive affect, less negative affect, and reinforced well-being. Results suggest that EAT interventions may have beneficial effects among persons diagnosed with schizophrenia and that a varied range of research methods is needed to create a solid evidence base for EAT interventions intended for the target group. © 2023 The Author(s). Published with license by Taylor & Francis Group, LLC.

Common mental disorders such as anxiety, depression and stress-related disorders are increasing worldwide, resulting in long-term sick leave and lower quality of life. Traditional treatment is often insufficient to facilitate the recovery process, and the need for holistic interventions that enable successful recovery is evident. Equine-assisted interventions have shown promising results in health promotion among people with mental disorders, and further research is needed to implement them within the range of available care. The aim of the study is therefore to describe experiences of a therapeutic equine-assisted group intervention for people with common mental disorders on sick leave. The study has a descriptive qualitative design with an inductive approach. Ten participants with common mental disorders on sick leave were interviewed after participating in a 12-week equine-assisted intervention and the data were analysed with conventional content analysis. The analysis generated the overall theme “The equine-assisted group intervention facilitates recovery,” which summons the four categories “The environment of the horses contributes to relaxation and an ability to be in the present,” “The presence of the horses facilitates supportive relationships in the group,” “Interplay with the horses entails physical activity and bodily improvements” and “Emotional interactions with the horses strengthen inner power.” In conclusion, equine-assisted interventions have the potential to facilitate recovery for people with common mental disorders by providing relaxation, promoting the ability to be in the present, cultivating supportive relationships and providing physical activity and bodily improvements as well as emotional interactions that strengthen the participants’ inner power. © 2024 The Author(s). Published with license by Taylor & Francis Group, LLC.

From the perspective of psychiatric and mental health nurses in Sweden, this discussion paper aims to position psychiatric and mental health nursing as a transformative force contributing to enforcing person-centered values and practices in health care. We argue the potential impact of psychiatric and mental health nursing on service user health and recovery, nursing student education and values, and the organization and management of health care. Psychiatric and mental health nursing is discussed as a caring, reflective, and therapeutic practice that promotes recovery and health. Implications for nursing education, research, management, and practice are outlined. © 2020 The Author(s). Published with license by Taylor & Francis Group, LLC.

This study aims to elucidate, from the children's perspective, the meaning for family life of a parent suffering a major depression disorder. Eight children and young adults were interviewed. Phenomenological-hermeneutic analysis generated two themes: (1) "Being a rescuing observer" with the subthemes, "Being attentive" and "Being considerate," and (2) "Being a frustrated observer" with the subthemes, "feeling discomfort" and "being out of it." Children's lives alternate between responsibility and loneliness as they wait for reciprocity in family life to return to normal. Children need support in order to manage their sense of responsibility and loneliness adequately.

Adopting positive health interventions is necessary to promote self-image, improve well-being, support meaningful social interaction and reduce loneliness, with benefits for psychological and physical health for persons with psychotic conditions. Raised awareness of the potential benefits of involving horses in these kinds of interventions is warranted. Thus, the aim of this study was to explore the role of the horse in equine-assisted interventions (EAI) as conceptualized among persons with psychotic conditions. Interviews were conducted with eight persons with psychotic conditions who had participated in an EAI, and data were analyzed following conventional qualitative content analysis. The results illustrate how the horse united the group and facilitated personal maturity both at a group level and at a personal level. In the group the horse facilitated interaction and became a healthy and normal topic of discussion. The interaction between the horse and others helped the participants to become aware of and reflect on behaviors of oneself and of others. At an individual level, the horse helped to develop participants’ identities and growth by offer mutual friendship. With its size and calming way of being, the horse evoked a healing power among participants who identified characteristics of themselves in the horse. Through its clear body language and communication, the horse facilitated personal maturity and development among the participants that would not have occurred without the horse’s presence.  © 2021 Taylor & Francis Group, LLC.

Patient education in mental health care is a conventional intervention to increase patients' knowledge about their illness and treatment. A provider-centered focus in patient education may put patients in a passive role, which can counteract their processes of recovery. There is an increasing emphasis on recovery-oriented practice, an approach that is aligned with the service user perspective, but little is known about health care staff's perspectives on person-centered mental health care. A qualitative approach was used to describe staff's experiences of being group leaders in a person-centered health education intervention in municipal services for persons with a persistent mental illness. The analysis of staff experiences revealed three core categories: (1) implications of the division of responsibility among local authorities, (2) awareness of facilitating factors of growth, and (3) the meaning of dialogue. These formed the theme Preconditions for Person-Centered Care. Further research is required to explore larger economic, political, and social structures as backdrops to person-centered mental health care, from the perspective of service users, families, health professionals, and the community at large. © 2013 Informa Healthcare USA, Inc.

Persons diagnosed with schizophrenia are not sufficiently offered health promotion interventions, notwithstanding their increased risk of bodily ill health. Physical activity is found to improve health and decrease psychiatric symptoms although, there is a challenge to motivate and increase physical activity in people with schizophrenia and innovative evidence-based treatment interventions are needed. The aim was to systematically review studies concerning equine assisted interventions among individuals diagnosed with schizophrenia. The findings of the six included articles indicate that therapeutic equine assisted interventions could be beneficial for individuals with severe mental illness such as schizophrenia or schizophrenia like disorders.

The main focus of psychoeducative interventions for people with persistent mental illnesses has been on providing information about symptoms of disease and its treatment. Supporting group contexts have been described as essential for the achievement of personal goals. A qualitative approach was used to describe participants’ experiences of a person-centered health education intervention in community mental health care. Participants expressed experiences of health processes in terms of stimulating content, development towards personal growth and group context with equality, when participating in the intervention. The findings support further investigation of health promotion approaches emphasizing individual preferences throughout the process of psychoeducation.

Even though the concept of health and its importance has been widely discussed in health care during recent decades, mental health services have been criticised for adopting a biomedical perspective, which does not sufficiently consider the concept of health. The aim of the present study was to investigate the psychometric properties of the Health Questionnaire, a newly developed questionnaire to measure patients' subjective experience of health in mental health services. A cross sectional study was performed using a sample of 139 outpatients in mental health services. A principal component analysis with varimax rotation was used to test the factor structure of the questionnaire. Cronbach's alpha was employed to test internal consistency and Cohen's Kappa assessed test-retest reliability. The final scale, which contained 22 items, derived from three factors (autonomy, social involvement, and comprehensibility) and showed a good reliability in terms of internal consistency. Test-retest reliability was moderate or better for 17 out of 22 items. The Health Questionnaire may enable further empirical studies on subjectively experienced health in mental health services and serve as a measure of outcome and to monitor quality of care.

The aim of this study is to describe the meaning of living with bipolar disorder (BD) based on individuals' views of the illness and their future. Interviews were conducted with 18 participants who resided in Sweden and had been diagnosed with bipolar disorder. Qualitative content analysis was employed. The findings revealed that daily life of those with BD was characterized by insecurity and challenges of accepting, understanding, and managing the illness. Increased hope of being able to influence the condition and receiving support to achieve a stable structure in life facilitates the management of daily life. Further research is needed on the next of kins' experiences of living with persons with BD. Copyright © Informa Healthcare USA, Inc.

Family and informal caregivers provide a substantial amount of care and support to people who experience mental health problems. The aim of this study was to explore mental health nurses', students' and service users' perceptions of the knowledge, skills and attitudes that are required by mental health nurses to work with families and carers using a qualitative methodology. Three themes emerged from the data: Knowledge of the family and how mental distress affects the family; working with the family - support and education; and valuing the role of the family. The three themes demonstrate the complexity of preparing mental health nurses to work with families and carers, and the article offers recommendations about how this might be achieved. © 2017 Taylor & Francis Group, LLC

News reporting about mental illness lack perspectives of the mentally ill themselves and it is almost exclusively psychiatrists who are accessed when healthcare staff is consulted. The perspective of mental health nurses might contribute to the public understanding of mental illness. The purpose of this study was to describe mental health nurses’ experiences of how mental illness is portrayed in media. Eight semi-structured interviews were conducted with qualified mental health nurses. A qualitative content analysis resulted in three categories: Negative portrayals of mental illness, Inconclusive images of mental illness and Biased dissemination of different perspectives. The conclusion of this study is that mental health nurses experience media portrayals of mental illness as negative and misleading with too much emphasis on the medical perspective while a holistic mental health nursing perspective is heavily obscured. Mental health nurses need to take a more prominent role in public reporting on mental health to resolve the current lack of relevant facts regarding mental illness. Further research is needed regarding portrayals of mental illness in social media and how the current lack of perspectives affects public perceptions of mental illness. In addition, further studies regarding the viewpoints of journalists reporting on mental illness are required. © 2019, © 2019 The Author(s). Published with license by Taylor & Francis Group, LLC.

The aim of this study was to elucidate the meaning of the lived experience of lifestyle changes as perceived by people with severe mental illness (SMI). People with SMI who have experience in managing lifestyle changes were interviewed (n = 10). The interviews were analyzed with a phenomenological hermeneutic approach. The findings reveal three themes: (1) struggling with inner and outer limitations, (2) on one's own but together with others and (3) longing for living a life in harmony. The meaning of lifestyle changes can be understood as a person's internal and external endeavors to make well-considered decisions about lifestyle changes. Support should focus on strengthening the person's self-efficacy and should be based on the person's experiences. © 2017 Taylor & Francis Group, LLC

In all social groups, major depression is an increasingly serious problem in modern society. Important aspects of a person's capacity for recovery are the person's own understanding of the illness and the ability to use this understanding to manage the illness. The aim of this study is to describe how individuals with major depression understand their illness and use their understanding to handle it. Twenty participants treated in community care for major depression as determined by the Diagnostic and Statistical Manual of Mental Disorders were interviewed between February and June, 2008. Content analysis of the interviews revealed three major themes: (1) awakening insight, (2) strategies for understanding and managing, and (3) making use of understanding, each with additional subthemes. Individual understandings of the illness varied and led to differences in the ways participants were able to handle their depression. In clinical care it is essential to support an individual's understanding of depression and his or her use of that understanding to handle the illness.

Mental illness among children and adolescents is increasing globally, and prescription of psychiatric drugs for children and adolescents with mental illness is increasing worldwide, including Sweden. Holistic health-promoting interventions have shown promising long-lasting significant health benefits in young individuals with mental illness, but holistic health-promoting mental health interventions are often disregarded due to a lack of systematic theory-based knowledge. Consequently, the lack of scientific knowledge thwarts implementation of equine-assisted therapy as an established intervention in mental health nursing for children and adolescents with mental illness. The purpose of the study was to better understand experiences of equine-assisted therapy among children and adolescents with mental illness. The study adopted an inductive approach and data was collected using photovoice methodology. Six young persons, 7–18 years of age, referred by a psychologist to the equine-assisted intervention due to mental health issues, were included in the study. Data was analyzed using qualitative content analysis. The results could be summarized by an overarching theme, a physical, emotional, and social milieu for growth, consisting of three subcategories: feeling relief from everyday stress and anxiety; nurturing self-esteem in a mutual friendship; and strengthening self-reliance through synchronized interplay. The results indicate that equine-assisted therapy has essential values closely related to the goals of mental health nursing. Further research should strive to attain even gender distribution in study samples and focus on how equine-assisted therapy could be thoroughly integrated into established nursing intervention for children and adolescents with mental illness. © 2022 the author(s). 

The experience of having a severe disease such as major depression affects all aspects of the individual's life, including family, work, and social functioning. Therefore, the aim of this study was to describe, from a salutogenic approach, women's conceptions of coping with major depression in daily life with the help of professional and lay support. Thirteen women, previously hospitalized for major depression, were included in the study. The women were selected by strategic sampling, and data were analyzed by application of a phenomenographic approach. Four descriptive categories emerged: Self-Healing, Managing, Receiving Social Support, and Finding Meaning. While working their way out of the depression, the women needed to undergo a process of transition, involving both a cognitive and an emotional understanding, which they subsequently translated into health-related actions. The task of psychiatric mental health nurses is to provide care that empowers patients. Future nursing research should explore the circumstances that empower these women to start the transition process, as this process appears to be vital for recovery from major depression.

Health has been a central concept in nursing science since the 18th century but the holistic concept of health that includes both the body and the soul, still has to be clarified. The concept of health is often unclear and represents an unreachable ideal state that can be hard to use as a realistic goal in nursing care. The aim of this study was to describe how the patient perceives the concept of health in mental health nursing. Twelve patients with experience of mental health nursing were interviewed and the data were analyzed with a phenomenographic approach. The patients described nine different perceptions that were divided into three descriptive categories: autonomy, meaningfulness, and community. All of these are important to achieve health. There is ambiguity about the possibility to influence the concept of health. Health is described, on the one, hand as a prerequisite to experiencing freedom and finding meaning in life and, on the other hand, it is believed that the search for meaning and the courage to fight and try in spite of the disease is what leads to health. The patients' descriptions are mostly about things that they need in the present time to achieve health, but health as a process with growth and potential for development does not appear that clearly. One conclusion is that mental health nursing must deliver a more process-focused nursing care where the concept of health is visibly used as a goal for all nursing interventions.

People with schizophrenia have an increased risk of experiencing physical ill health and thus risk premature death. It is important to gain knowledge about the next-of-kin's experiences of lifestyle interventions in order to increase the understanding of the development of health promotion. This study aimed to describe the experiences of next-of-kin of lifestyle interventions for people with schizophrenia. Ten next-of-kin to people diagnosed with schizophrenia were interviewed and content analysis was used to analyze the data. Three categories emerged in the analysis: Low prioritization of physical health, Patients' needs for motivational support and Next-of-kin's' limited and distant participation. Mental health nurses need a holistic view of human beings and to include the patients' physical health and the role of the family in their responsibilities. Further studies are needed that focus on the views of the next-of-kin and the staff from the mental health services about the care and support needs for promoting physical health in this patient group. © 2020 The Author(s). Published with license by Taylor and Francis Group, LLC.

The aim of this study is to describe mental psychiatric health nurses' experiences of caring for persons with the dual disorders of major depression and alcohol abuse. The study was conducted in 2003 on three psychiatric wards located in two general hospitals in Sweden. The study group comprised 11 registered nurses with experience of caring for patients with dual disorders. The data were analyzed by means of qualitative content analysis. The findings revealed three categories: Enabling a good level of cooperation with patients; Facilitating continued care and treatment; and Understanding barriers to cooperation with patients. Building a trusting relationship in order to enable cooperation with patients was the basis for continued care and treatment. The nurses needed more training and multidisciplinary knowledge in order to meet the particular clinical needs of this patient group. Nurses have an important obligation to utilize the best available evidence, including research findings and other scientific sources.

Mental health care tends to be dominated by a biomedical perspective at the expense of a more recovery-oriented approach. Research on nurse-led interventions intended to strengthen the patient’s ability to manage anxiety is sparse in this context. The aim of this study was to describe nurses’ experiences of the use of anxiety communication notes in nursing patients experiencing anxiety in mental health inpatient care. Data were collected by interviewing twelve nurses working in two mental health inpatient care wards in southwestern Sweden. Semi-structured interviews were conducted, and qualitative content analysis was used to analyze the data. Findings showed that the use of anxiety communication notes was perceived to provide a nursing structure to foster the development and practice of adaptive anxiety management through a visual representation for mutual understanding of the patient’s anxiety pattern. The nurses could also use the anxiety communication notes to support nurse-patient communication and facilitate increased participation and empowerment in the patients’ anxiety management. © 2023 The Author(s). Published with license by Taylor & Francis Group, LLC.