scholarly journals An Interpretation of Four Men's Experiences of Suicidality

2021 ◽  
Author(s):  
◽  
Brian Phillips

<p>Mental health nurses are frequently called upon to care and provide intervention for suicidal men. While there is substantial literature on male suicide, far less is known about the understandings men have of their suicidal experiences. This study draws upon Gadamer's philosophical hermeneutics to explore the understandings that four men have had of their past suicidal experiences. The interpretations developed in this study, as far as possible, make explicit use of my own particular horizon of meaning as researcher and mental health nurse, and as such, seeks to engage with a tradition of mental health nursing. In addition, by consciously bringing an anti-essentialist perspective of masculinity to this process, I explore the way in which gender impacts on men's suicidality. The primary source of information for this study is in-depth, open-ended conversations with four men of European descent in their middle adult years who were asked to talk about their past experiences of suicidality. The interpretations developed here show that for these men, the hermeneutic fusion of history, language, and sociocultural context, provided limited possibilities with which they were able to construe themselves as 'fitting in' with normative standards. These constraints, that are otherwise taken-for-granted and invisible, became explicit through their experience of ongoing victimisation. Furthermore, early understandings of these experiences became a potent horizon of meaning from which they then came to understand later difficult experiences. Victimisation became constitutive of an understanding of self as fundamentally different and (hierarchically)'less-than' other men. Ultimately, suicidality emerged out of a background of ever-present psychological pain accompanying a construction of self as being unable to see themselves as ever 'fitting in'. These men did not regard themselves as having recovered from suicidality, but remain in a process of recovering. This process did not mean figuring out how to 'fit in', or become 'normal' men, but rather, to live meaningfully as men in spite of not 'fitting in' with the sociocultural ideal. This involved a process of repeated cycles of revisiting and reflecting on their personal histories from vantage points permitting understandings that opened up opportunities for personal growth and learning. Relationships were significant for either enabling or disabling this process. Recovering was therefore a continual and idiosyncratic process, rather than an outcome of a specific technique or knowledge. The position taken in this study is that mental health nursing seeks to engage with people and work with them in collaborative, respectful, human relationships. It is argued that mental health nurses work with an individual's situated understandings rather than delivering prescribed treatment determined by diagnosis. Hence, viewing suicidality as socioculturally situated and historically emergent suggests mental health nurses must closely attend to the way in which we bring ourselves into relationships with our clients so that we are then able to create opportunities for change. The exploration of suicidality in this study also alerts us to the possibility that through fusion with clients' pre-understandings, mental health intervention can inadvertently further constrain choices to survive.</p>

2021 ◽  
Author(s):  
◽  
Brian Phillips

<p>Mental health nurses are frequently called upon to care and provide intervention for suicidal men. While there is substantial literature on male suicide, far less is known about the understandings men have of their suicidal experiences. This study draws upon Gadamer's philosophical hermeneutics to explore the understandings that four men have had of their past suicidal experiences. The interpretations developed in this study, as far as possible, make explicit use of my own particular horizon of meaning as researcher and mental health nurse, and as such, seeks to engage with a tradition of mental health nursing. In addition, by consciously bringing an anti-essentialist perspective of masculinity to this process, I explore the way in which gender impacts on men's suicidality. The primary source of information for this study is in-depth, open-ended conversations with four men of European descent in their middle adult years who were asked to talk about their past experiences of suicidality. The interpretations developed here show that for these men, the hermeneutic fusion of history, language, and sociocultural context, provided limited possibilities with which they were able to construe themselves as 'fitting in' with normative standards. These constraints, that are otherwise taken-for-granted and invisible, became explicit through their experience of ongoing victimisation. Furthermore, early understandings of these experiences became a potent horizon of meaning from which they then came to understand later difficult experiences. Victimisation became constitutive of an understanding of self as fundamentally different and (hierarchically)'less-than' other men. Ultimately, suicidality emerged out of a background of ever-present psychological pain accompanying a construction of self as being unable to see themselves as ever 'fitting in'. These men did not regard themselves as having recovered from suicidality, but remain in a process of recovering. This process did not mean figuring out how to 'fit in', or become 'normal' men, but rather, to live meaningfully as men in spite of not 'fitting in' with the sociocultural ideal. This involved a process of repeated cycles of revisiting and reflecting on their personal histories from vantage points permitting understandings that opened up opportunities for personal growth and learning. Relationships were significant for either enabling or disabling this process. Recovering was therefore a continual and idiosyncratic process, rather than an outcome of a specific technique or knowledge. The position taken in this study is that mental health nursing seeks to engage with people and work with them in collaborative, respectful, human relationships. It is argued that mental health nurses work with an individual's situated understandings rather than delivering prescribed treatment determined by diagnosis. Hence, viewing suicidality as socioculturally situated and historically emergent suggests mental health nurses must closely attend to the way in which we bring ourselves into relationships with our clients so that we are then able to create opportunities for change. The exploration of suicidality in this study also alerts us to the possibility that through fusion with clients' pre-understandings, mental health intervention can inadvertently further constrain choices to survive.</p>


2003 ◽  
Vol 9 (4) ◽  
pp. 111-114 ◽  
Author(s):  
Nancy Hanrahan ◽  
Gail W. Stuart ◽  
Pat Brown ◽  
Mary Johnson ◽  
Claire Burke Draucker ◽  
...  

Managing the supply of psychiatric-mental health nursing labor, determining the financial incentives associated with the provision of services by these providers, and ensuring optimal patient and cost outcomes are critical elements of cost control and patient safety in the current health care market. Knowledge of the psychiatric-mental health nursing workforce is needed to plan and evaluate cost-effective programs to accomplish the aforementioned elements. However, the psychiatric-mental health nursing workforce data are woefully inadequate. This paper will review the extent to which national data sources contain workforce information on psychiatric-mental health nurses.


Author(s):  
Marjorie Lloyd

In this chapter we return to the story of Anthony and his brother David, who we originally met in Chapter 4, and Joyce, who first appears in Chapter 5. Previously we considered the role of the mental health nurse in working with people experiencing acute mental health crisis. This chapter seeks to consider how as mental health nurses we might go on to work with these people to support their rehabilitation and reintegration into the community. The chapter opens by outlining some key principles of recovery and proceeds to demonstrate how these ideas might be implemented in working with both Anthony and Joyce. “The way I was feeling my sadness was mine. When I was in hospital staff rarely took time to find out what this was like for me. Not taking the time often fuelled what I was thinking: ‘I’m not worth finding out about.’ Nigel Short (2007: 23)” This service user describes how it feels to live with mental illness continuously throughout their lives, not just while they are in hospital. Professional staff may contribute to this feeling if care planning becomes too focused upon symptoms and treatment rather than person-centred care and recovery. In this context, recovery should not be seen as a new concept; rather it can be traced back at least 200 years to one of the earliest asylums, the Tuke Retreat in Yorkshire. “For it was a critical appraisal of psychiatric practice that inspired the Tuke at York to establish a clinical philosophy and therapeutic practice based on kindness, compassion, respect and hope of recovery. Roberts and Wolfson (2004: 37).” Later, during the 1960s, The Vermont Project (an American psychiatric facility) also published research on successful rehabilitative practice that was based upon ‘faith, hope and love’ (Eldred et al. 1962: 45). However, much of the current focus upon recovery practices is based on longitudinal studies in America, services in Ohio, service users were asked to identify what was important to them. This resulted in the Emerging Best Practices document that is recommended guidance in the UK today (NIMHE 2004).


2019 ◽  
Vol 8 (2) ◽  
pp. 68-69
Author(s):  
John Fowler

In this new series, John Fowler, a noted nursing author, will explore the use of reflection in mental health nursing. Over the next eight issues, John will be examining some of the techniques that mental health nurses can use to aid their own reflection and how reflection can be applied to clinical practice and management. The series will cover portfolios, reflective learning, reflective evidence, the use of feedback and reflection in all aspects of life.


2020 ◽  
Vol 9 (2) ◽  
pp. 1-3
Author(s):  
John Fowler

This series on reflection is examining the place and importance of reflection for all mental health nurses. This article will explore how those two important areas of management and reflection can come together and from a Gestalt view point, be greater than the sum of the parts.


2019 ◽  
Vol 8 (4) ◽  
pp. 173-174
Author(s):  
John Fowler

In the third part of this series on reflection for mental health nurses, John Fowler examines the analogy of mirrors and lenses in the art and science of reflective nursing practice.


2019 ◽  
Vol 8 (2) ◽  
pp. 81-87
Author(s):  
Jan Macfarlane

This is the second article in a series of articles that explores the meaning of positive psychology and the importance of applying the latest research findings for the wellbeing of the mental health workforce. There will be an historical outline of positive psychology, showing it is not as ‘new’ as people may believe. The article sets the context and explains key terms through the underpinning theoretical work of Martin Seligman. This is followed by an explanation of how it is relevant to mental health nursing, five interventions mental health nurses can use to help encourage positive thinking, and a discussion on making new skills via neuroplasticity. The practical tasks provided in the boxes throughout the article will help the reader to understand what happiness means to an individual and how it can be developed with evidence-based, user-friendly effective exercises.


Author(s):  
Mayte Palacio Roda ◽  
Natalia Del Campo Robles

This study aims to approach the sexuality in mental health patients in Asturias, using the Delphi technique. By sending three successive questionnaires, the views of 29 mental health nurses were sought. The first questionnaire raised open questions, the second one made a series of statements for nursing professionals to show their degree of agreement and the third one asked the experts to prioritize the most relevant sentences. The results show a consensus that the approach is limited, due to several factors: lack of training of professionals, lack of tools to guide exploration, and lack of time during working hours. Professionals feel more comfortable tackling sexuality with patients of their same gender. There is no consensus regarding the influence of the age or severity of the diagnosis on the approach to sexual aspects, despite what is expected compared to other studies, in which these factors act as clear limitations. In order to improve the quality of care, it would be necessary to consider sexuality as an aspect of comprehensive patient care, to increase specific training in sexuality and to carry out intra-personal work. Keywords: sexuality,mental health, nursing care, sex education, peer review,Delphi technique.


2021 ◽  
Author(s):  
Mary Chambers ◽  
Sue McAndrew ◽  
Fiona Nolan ◽  
Benjamin Thomas ◽  
Paul Watts ◽  
...  

Abstract Background: A key component of caring for service users (SUs) in acute mental health inpatient environments is Therapeutic Engagement (TE). To that end, the Therapeutic Engagement Questionnaire (TEQ) was developed and validated. The TEQ measures TE between SUs and registered mental health nurses (RMHNs) from the perspective of both parties and can quantify and recognise how nurses engage with SUs and monitor this activity as well as its enhancement of SU care and recovery. The aim of this study was to explore the views of SUs and RMHNs in relation to the TEQ and how it could be adopted into clinical practice within an acute inpatient environment.Methods: As part of the validation stage of the development of the TEQ, the views of 628 SUs and 543 RMHNs were collected using a qualitative approach by way of free text at the end of the questionnaire. Two questions required free text response: – ‘what do you think of the TEQ?’, and ‘how can it be utilised?’Results: Following thematic analysis, it was found that both sets of participants stated that such a tool could be utilised to improve the service, could help nurses with reflective practice, be utilised as part of clinical supervision and to aid nurses’ professional development. The nurse participants also stated that such a tool would help track SU participation and enablement in their care. Furthermore, the nurses noted that the tool would help to reinforce the core ‘caring’ value of nursing and the overall goal of recovery. The SUs added that a TE tool would recognise the work of mental health nurses and provide them with a clear opportunity to express their views in relation to nursing staff.Conclusions: Therapeutic engagement (TE) has been identified as part of the repertoire of mental health nursing and both groups of participants identified how a tool to assess this construct may be utilised in day-to-day clinical practice to the benefit of each group.


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