Towards relational recovery: Nurses’ practices with consumers and families with dependent children in mental health inpatient units

Abstract

Facilitating parent-child and family connections during parental hospitalization provides important opportunities for mental health services to support individual and family recovery. Nurses are often the primary point of contact for families in the inpatient context. They play an integral role in the care provision of consumers and families and in supporting consumers' recovery. The aim of the present qualitative study was to explore nurses' practice with families in inpatient mental health settings in the context of designated family rooms. Three themes were derived from the thematic analysis of semistructured interviews with 20 nurses from four mental health inpatient units. Nurses experienced tensions within their roles in balancing safety and risk, a lack of confidence in family-focused practices in relation to role expectations, and challenges in juggling nursing care ideals with the contemporary realities of inpatient practice. A family-centred relational recovery approach is recommended for mental health services, which is underpinned by family-focused policies and processes, and supported at an organizational, managerial, and local-unit level. At an individual level, nurses need professional development on the models of care they practice in, explicit role clarity on their practice with families, and education on evidence-based brief family interventions.

Barriers to recovery‐focused care within therapeutic relationships in nursing: Attitudes and perceptions

“…Farrelly et al 's () review of 13 articles on therapeutic relations with providers and consumers in the mental health community supports this: while providers and consumers agreed on the need for shared trust, respect and collaboration, providers felt what they were to accomplish was unclear and questioned whether or not it was congruent with their roles (Farrelly et al, ). Foster and Isobel () found that nurses in their study were aware of this incongruence and voiced uncertainty in lack of confidence over their abilities, which impacted the recovery‐focused relationship. This may be complicated by an issue addressed earlier: the lack of institutional clarity in many countries on how to actualize broad recovery approaches to care (Baker et al, ).…”

Family‐focused recovery: Perspectives from individuals with a mental illness

“…family, friend, or community) nor how these different relationships might promote or hinder an individual's recovery. While Foster and Isobel () recommend a family‐centred relational recovery approach, they found that mental health nurses lack the confidence to support such practice and require specific training with organizational policy at all levels. Maybery & Reupert () synthesized family‐focused practice with recovery in terms of (1) acknowledging the family role of the client (e.g.…”

Family‐focused practice with EASE: A practice framework for strengthening recovery when mental health consumers are parents

“…). Due to this, there are mounting calls for more inclusive approaches that consider adults in the context of their family life and recognize child, parent, and family relationships and the needs of parents (Foster & Isobel ; Foster et al . ; Goodyear et al .…”

“…Evidence indicates there are service‐related, clinician‐related, and family‐related barriers to provision of mental health family‐focused care. There is a substantial body of evidence that, while nurses and other clinicians recognize the importance of addressing consumers’ needs as a parent and family member, they can struggle with a lack of confidence, lack of role clarity, and lack of clinical skills and knowledge to engage readily with parent/consumers and their children about mental illness (Foster & Isobel ; Goodyear et al . ; Maybery et al .…”

“…). Barriers also stem from clinicians’ attitudes, knowledge, and skill set on child and family support needs (Foster & Isobel ; Grant et al . ), and from parents, children, and adult family members who may be reluctant or not available to discuss family issues (Grant & Reupert ; Maybery et al .…”