No abstract

Forming interpersonal therapeutic relationships with mental health Service Users remains a key aspect of the practice of Psychiatric/Mental Health nurses. Given the omnipresence of the concept within the relevant literature the reader could be forgiven for asking: why would Psychiatric/Mental Health nurses opine about something so basic, so ubiquitous and so central to the theory and practice of our discipline? While the authors could locate no substantive argument that refutes the role or value of such relationships, a sizable, growing and reasonably consistent body of work has emerged, which appears to indicate that this centrality and value is not necessarily reflected in many clinical practice settings. Accordingly, we draw on the published evaluations of mental health care emanating from the United Kingdom, Portugal, Canada, Switzerland, Germany and Australia, compare these findings and highlight similarities or/and congruence and discuss a range of issues arising out of the findings. Alas, the findings seem to depict a mental health care inpatient experience that is often devoid of warm therapeutic relationships, respectful interactions, information or choice about treatment and any kind of formal/informal 'talk therapy'. Instead such care experiences are personified by: coercion, disinterest, inhumane practices, custodial and controlling practitioners and a gross over use of pharmacological 'treatments'.

Peer work is now known in Switzerland for 10 years and has developed strongly. The aim of the study was to describe peer support specialists’ (PSSs’) work conditions and job satisfaction, as well as the challenges of integration into the workforce in Switzerland. A further aim was to identify possible development topics in the preparation of PSSs for working with peer support work (PSW) training and interventions within the working field. We launched a survey with a self‐developed questionnaire for people with lived experiences with mental illness and recovery who were working as PSSs or experts by experience in education, research, politics, and other areas in the German‐speaking region of Switzerland. The survey took place from 1 September 2017 to 15 November 2017. The results show that PSSs were working mostly in 1:1 contact with service users and in education and noticeably less in politics and research. Their work conditions and job satisfaction seemed good. Most PSSs had job descriptions matching their duties, were satisfied with their salaries, and indicated being satisfied or very satisfied with their work. Amongst other aspects, the greatest challenge reported was integration into the inter‐disciplinary working team. PSS training should better consider the working areas of experts by experience in the fields of politics and research to reinforce employment opportunities in these work areas. To increase the impacts of PSSs and to improve integration into the workspace, the preparation of professionals and institutions should be improved by means of information sessions, trainings, and guidelines.

Non-adherence to medication is highly prevalent in patients with schizophrenia. Adherence therapy aims to improve medication adherence of these patients by applying techniques of cognitive behavioural therapy, psycho-education, and motivational interviewing. Even though adherence therapy is frequently discussed and researched, its effectiveness is still uncertain. This paper aims to review the effectiveness of adherence therapy on the medication adherence of patients with schizophrenia. To this end, six electronic databases were systematically searched for randomized, controlled trials on adherence therapy from January 2002 to March 2013. Four trials met the inclusion criteria and were incorporated into the review. The findings suggest that adherence therapy does not improve patients' medication adherence in comparison to treatment as usual or a control intervention. However, all the studies reviewed showed high-adherence ratings at baseline. Thus, further well-designed studies that target adherence therapy to patients who are non-adherent to their medication are needed for a more profound understanding of its effectiveness. In addition, if adherence therapy is aimed not only at improving medication adherence, but also to reach an agreement whereby the patient's decision not to take his medication is accepted, the shared decision-making process needs to be assessed as well.