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As a philosophical position, pragmatism can be critiqued to distinguish truth only with methods that bring about desired results, predominantly with scientific enquiry. The article hopes to dismiss this oversimplification and propose that within mental health nursing, enquiry enlightened by pragmatism can be anchored to methods helping to tackle genuine human problems. Whilst pragmatists suggest one reality exists, fluctuating experiences and shifting beliefs about the world can inhabit within; hence, pragmatists propose reality has the potential to change. Moreover, pragmatism includes being cognisant of what works to whom reality concerns, making reality context‐driven, with a view to understand how actions shape experiences so what is generated has usefulness. Hence, it somewhat follows pragmatism can inform mental health nursing, after all, nursing is a discipline of action, and awareness is needed in how actions produce experiences that patients find helpful. Given the principles of recovery are preferably adopted in mental health care, the paper will explore how pragmatism can help nurses move towards that goal; specifically, with patients voicing their experiences. This is because like pragmatism, recovery subscribes to hope that reality can progress, and through meaningful experiences and beliefs, patients have expertise about personal difficulties alongside how life may flourish, despite mental illness.

Accessible Summary What is known about the subject? Risk in psychiatry involves harm to self or others owing to mental health difficulties, for example iatrogenic effects of treatment, self‐harm, suicide and violence. Risk management is a framework to minimize risks, comprising of risk assessment, generation of risk management plans and evaluation of interventions. Literature has extensively explored risk management and presented a critique that its practices can lead to patient harm. However, there is a paucity of literature about what patients identify as helpful risk management practices, despite the potential for such patient views to ameliorate harm and improve mental health care. What this paper adds to existing knowledge Interpersonal relationships with clinicians, and communication that keeps patients involved and informed of management processes, were found to be central to beneficial risk management practices, while patients having agency and autonomy to influence their participation was also important. Beneficial interpersonal relationships and connectivity in the form of patients’ wider community of support were found to be influential in aiding risk management. Meaningful relationships, and particularly peer support, that maintained personal and collective identities were prevalent in the literature. What are the implications for practice? Rendering risk management more visible and accessible in practice might cultivate an openness that promotes patient participation. This includes drawing on a wider network of support, for example the patient’s friends and family, as well as having advocacy utilizing peer support. AbstractIntroductionMinimizing the harm that patients pose to themselves and others, due to mental health difficulties, is a central component of risk management in psychiatry. However, risk management itself can cause patient harm, but despite this and the potentially informative value of lived experience, little is known about what patients want or expect from risk management.AimTo review research and explore what patients consider beneficial in risk management practice.MethodA mixed studies systematic review utilizing PRISMA guidelines, alongside a convergent qualitative design to categorize findings.ResultsTwelve papers were identified, generating two categories of beneficial practices: interpersonal relationships and communication with clinicians; coupled with patient agency in their own risk management.DiscussionConnectivity appears important. Particularly patients feeling involved, and their voices being heard in both the identification of risks and then shaping risk management practice. Moreover, this included involvement of friends, family and peers to widen input and supportive networks beyond clinical relationships.Implications for PracticeRisk management needs to be an accessible part of care, which is more inclusive of patient views and needs. The latter might also be aided by drawing on the patient's wider community in order to provide more effective support and r...

Student transition into higher education can set the foundation for success at university. However, some students, perhaps in increasing numbers, find this transition difficult. This study explores contemporary students' experiences when transitioning into Higher Education (HE) to gain an up to date picture of the multiple, potential sources of distress. Focus groups and interviews were held with a total of 10 participants. Interviews were transcribed and analysed using thematic analysis. The data suggests that students find a number of things difficult about their transition into HE. Overall, our findings suggest that some find challenges adapting to living independently, while some are also unprepared for independent study at university. These challenges and feelings of lack of preparedness can be experienced as particularly distressing for students who can feel that even their early academic performances are directly tied to their future opportunities for both success at university and later life. One of the main sources of support students seem to have are their new social networks. However, even establishing these networks can become an additional challenge. In the discussion, we explore how the existing literature generally supports these findings. The discussion also considers both if and why the challenges of learning and living independentlya consistent and longstanding part of university life -appears to be causing more problems now than previously. We provisionally introduce a new concept and focus for work in this area SAILL (Struggles Around Independent Learning and Living) and consider whether such a focus might help us conceptualise future work in this area.