European Psychiatric/Mental Health Nursing in the 21st

Century A Person Centred Evidence Based Approach

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Editors
José Carlos Santos John R. Cutcliffe
Escola Superior de Enfermagem de Cutcliffe Consulting
Coimbra Kingston
Nursing School of Coimbra Canada
Coimbra
School of Nursing
Portugal
Coimbra
Portugal

ISSN 2366-875X     ISSN 2366-8768

Principles of Specialty Nursing
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Foreword I

According to various national mental health-care policies and position statements

regarding contemporary mental health care, the person who uses such services (i.e.,
client, service user) is no longer a passive recipient. The service user is no longer
“reduced” to being little more than a disease or malfunctioning brain. And the care
context should no longer be one dominated by doctors/nurses, wherein the care is
focused on diagnosis, symptomatology, and associated pharmacological responses.
The National Survivor User Network (accessed 30 January 2017), for instance,
highlights how the mental health service user involves the:
active participation of a person with lived experience of mental distress in shap-
ing their personal health plan, based on their knowledge of what works best for him.
These policy statements, which show a large degree of convergence and consis-
tency across international borders, indicate that mental health service users can no
longer be considered as “third parties,” disconnected from their own treatment and
the health system. In contemporary European mental health care, the service user
has to be considered as a “partner,” the cocreator/codesigner of the care pathway,
and, importantly, an expert by experience. And so for someone who is a passionate
advocate for service users, it is so very heartening and reassuring to read a
Psychiatric/Mental Health nursing textbook that encapsulates the values and prac-
tices inherent to these policies and position statements. It is uplifting to read a book
in which the role(s) and the involvement of the service user are addressed through-
out and, simultaneously, reflect innovation and evidence-based practice in
Psychiatric/Mental Health nursing.
Furthermore, one of the defining characteristics of person-centered P/MH nurs-
ing is the desire to form partnerships with service users, work with (alongside)
rather than work “on” such individuals. P/MH nurses wishing to practice with such
a person-centered or humanistic focus regard the service users as experts (and own-
ers) of their own experiences and their own care. Indeed, in such relationships, both
parties are recognized as human beings having the same values and the same rights
in the promotion of their interests. An informed service user will then be able to
choose among the various treatment options and will feel as if he/she is an actor of
its treatment. Similarly, an informed P/MH nurse would consider the whole of the
service user’s situation and challenges, taking intrapersonal, interpersonal, familial,
professional/occupational, and social/environmental factors/experiences into

v
vi Foreword I

account when responding to the service user’s needs and tailoring and planning the
care in line with their needs. This holistic and integrated approach allows for a
greater care consolidation and has a beneficial influence on outcomes like recovery,
user’s satisfaction, and security of care. And so upon reading the book, I took great
comfort and solace from how the editors had integrated these key concepts and used
them as the underpinning for the individual chapters.
Upon reading the book, I was also struck by a further key underpinning for this
book, namely, that of evidence-based or evidence-informed practice. I was also
delighted to see how the editors have linked evidence-informed P/MH nursing prac-
tice with the service user involvement. Evidence indicates that mental health service
user involvement in treatment/policy making can and does have a positive impact. It
enables a greater understanding of the service user’s whole situation, experiences,
background, and “environment” and thus enables services to be shaped to the user’s
need. This increases the quality of the care and the cost-effectiveness. But, as one of
the authors rightly writes, this approach can be only sustainable if users are primar-
ily considered as citizens; this concept of citizenship is central to relation and par-
ticipation in society. This is the first P/MH nursing textbook that I have read that
brings these three key concepts together into one philosophical underpinning for the
book and, importantly, demonstrates that they are not mutually incompatible, far
from it.
The book also highlights how European and occidental mental health care per se
still has a way to go before it can claim to have endorsed and operationalized per-
soncentered, holistic, evidence-informed, and service user-informed mental health
care. To get there, this requires of course that mental health-care professional’s
behavior and culture change fundamentally. For service users and those champion-
ing service user involvement, the care model should be based on the client’s needs
by asking this question: “What matters to you?” Communication styles and patterns
have to become more transparent and explicit at the individual, team, and organiza-
tion level. Education of P/MH nurses, psychiatrists, psychologists, and other mental
health professionals should include a holistic vision of the care as well as the multi-
professional care model in order to remove the barriers between different profes-
sions and specialties. Adopting this configuration of mental health care remains
challenging and contains unanswered questions; however, it represents the mental
health-care system of the future, and this book completely reflects this trend.
As a result, I endorse and recommend this book without hesitation or pause.
For any mental health practitioner, especially P/MH nurses, who wish to adopt a
progressive, emancipatory approach to practice, this book is a must read.

Brussels, Belgium Françoise Charnay-Sonnek

Foreword II

Back in 1984, at the tender age of 18, I took a job as a nursing assistant in an acute
male psychiatric ward of a mental hospital outside Bristol in the UK. I only worked
there for a few months—before disappearing off to explore India—but the experi-
ence remains clearly etched in my mind. I particularly remember one young man—
let’s call him Rob—who was admitted shortly after I started, highly agitated, restless
and manic. I’d never seen anyone so unwell. Yet four months and a few interesting
incidents later, Rob walked out of that hospital with a smile, a wave and his head
held high, his mind mended. Since I too was young and had no formal nursing quali-
fications, I spent a lot of time on the ward with Rob and so was able to witness his
journey to recovery on an almost daily basis. At the end of my time working there, I
thought I would be unlikely to find such a rewarding job ever again, and so that has
proved in many ways. Working with numbers and policies and forms is not nearly as
interesting as directly working to help people get better from mental health problems.
I begin with this little account because it speaks to two pivotal issues underlying
the mental health nursing profession (and this book): the value of mental health and
our individual as well as collective need to nurture, protect and—where indicated—
restore it and the potential for and power of recovery from mental health problems,
both in its clinical and personal sense. I don’t know what happened to Rob after that
hospital admission, but at discharge his mental health state was evidently stabilized
and his functional capacities were restored to the extent that he was able to go back
to his course of study.
Our mental health and well-being is a precious but fragile asset, shaped by a
myriad of different factors that may be either protective or harmful. It is therefore
appropriate and reassuring that due place and recognition is given in this new text-
book to the underlying determinants of mental health and the explicit adoption of a
biopsychosocial approach to its understanding. Improved knowledge and awareness
about the many possible factors that may lead to someone becoming ill and coming
into contact with mental health services would seem to be a vital prerequisite for
a more nuanced and holistic response to a person’s needs. The pursuit of a person-
centred approach to mental health nursing is indeed a recurring and deservedly cen-
tral theme of this book and one that resonates strongly with broader (inter)national
agendas to strengthen health systems and workforce development policies.
In this volume, attention is also given to the needs of particular subpopulations,
including refugees and migrants. Europe is witnessing a huge inward movement of

vii
viii Foreword II

people, many of them scarred by conflict, civil unrest, or persecution, which not
only increases the numbers of people who could benefit from decent, responsive
mental health services but also poses new challenges for mental health nurses and
other frontline workers, including issues of cultural sensitivity and language. These
and other issues are nicely picked up in a section devoted to the competencies
required of nurses working in mental health.
A further important challenge and need concerns how to foster effective collabo-
ration or joint working arrangements with other professional groups. There is more
than enough evidence to support the value of collaborative care in its true sense, but
all kinds of real-world barriers seem to get in the way of its proper implementation,
including weak clinical governance, vertical budgeting arrangements and ill-defined
roles and responsibilities. So a further competency need extends to working well
with other health professionals as well as working well with users of services! In
support of this strategic need, the WHO Regional Office for Europe has had the
pleasure of hosting a number of knowledge exchange meetings between lead repre-
sentatives of staff groups active in mental health in the region—including Horatio.
A final critical area of strategic need relates to the inclusion of service users in
the processes and decisions that affect their lives. This is a foundational principle of
the WHO European Mental Health Action Plan 2013–2020 and one given renewed
emphasis in a recent (2017) Report of the Special Rapporteur to the UN on the
right of everyone to the enjoyment of the highest attainable standard of physical
and mental health. Issues around the engagement, involvement and participation
of service users are explored in Chap. 3 of this book, including issues of informed
consent, shared decision-making and legal capacity. This has also been a major area
of developmental work for WHO over the last decade, culminating in the release of
a comprehensive set of QualityRights training and guidance materials for assessing
and improving standards of care and human rights protection across different men-
tal health-care settings and in ways that are fully in line with the UN Convention on
the Rights of Persons with Disabilities. It is incumbent on mental health nurses to
be not only cognizant but also respectful of the human rights of those whom they
are caring for.
I congratulate the editors and authors for putting together this new book and
share the hopes and expectations they have for the translation of a person-centred,
evidence-based and rights-oriented approach to mental health promotion, protection
and restitution into everyday nursing practice.

Dan Chisholm
Programme Manager for Mental Health
Division of NCDs and Promoting Health through the Life-Course
WHO Regional Office for Europe, Copenhagen, Denmark
Preface

Why Another Psychiatric/Mental Health Nursing Textbook?

That is a good place to start.

In our long careers in psychiatric/mental health nursing, neither of the editors has
ever found one textbook that featured the key emphases and elements that we
wanted and needed to see. Sure, some textbooks included some of these desired
emphases and elements; those published during the last ten years or so may have
included material on evidence-based practice. Others have something of a humanis-
tic or person-centred focus. One or two have eschewed the dominant bio-psychiatry,
pharmacologically-skewed, and containment driven (i.e. defensive practice) domi-
nant discourse of most Occidental, contemporary mental health care. And a few
have made some effort to reflect a European emphasis—to a greater or lesser extent
and with mixed results. But no P/MH textbook has brought these emphases
together—up until now. For those involved in leading the writing, editing and pro-
duction of this book, this publication represents the first genuinely European,
Person-centred, evidence-based, P/MH nursing textbook that questions the hege-
mony of bio-psychiatry, places the human connection and therapeutic relationship
as central and sees service users as our partners in care.
The initial idea for the book belongs with Jose, and with apologies to Tolkien,
‘the tale grew in the telling’ once this became a collaborative, co-edited text with the
addition of John. One of our early and easy design decisions was to compile a list of
contributors that genuinely represented and reflected as many European nations as
possible rather than having the more typical, ‘Anglo-Saxon’-heavy author composi-
tion. For a genuinely European P/MH nursing textbook, the Editors felt it should
include contributions emanating from lesser known European authors and often
unrepresented European nations. Further, the editors felt that the book could have
more utility and applicability if we invited a few contributions from non-European
scholars, arguably broadening its appeal and widening the audience that might see
something meaningful and experience a ‘phenomenological ah ha!’
As with most journeys, our path from conceptualisation to realisation was nei-
ther linear nor lacking turbulence. And at the risk of sounding trite, maybe there was
something worthwhile and enabling in such struggles? The destination ‘tastes’ even
sweeter for the challenges encountered en route. And so the project that began in

ix
x Preface

earnest in 2016 comes to fruition in 2018. Maybe as the textbook evolved during its
production, it may also be the case that the editors (and authors?) are changed as a
result of their experiences.
In closing, if the contributions from the authors, representing around 20 different
countries, are anything to go by, there remains an international appetite for the
form(s) of P/MH nursing and mental health care featured and focused on in this
book, both in the mental health care providers and the services users—the recipients
and consumers of such care. This is heartening. While the published evidence seems
to suggest that the passion for interpersonally focused P/MH nursing care may have
passed its zenith, the same body of work continues to highlight that desire that ser-
vice users have to receive and engage in such care. And so to see these key ideas
embraced and embedded throughout this book gave the editors hope for the future.
After all, as Peplau (1995, p.x), the so-called Founding Mother of P/MH nurse,
stated:

Despite our current emphasis on medical diagnoses, sophisticated technology, economic

cutbacks and “quick fixes”, what patients need most in the midst of this health care maze is
sensitive and caring individuals who are willing to enter into interpersonal relationships that
foster hope and prevent hopelessness.

Coimbra, Portugal  José Carlos Santos

Kingston, Canada John R. Cutcliffe
November 2017
Acknowledgements

The editors have a number of people and organisations that they need to offer their
profound thanks to, and without whom this book could not have been produced.
Firstly, to each of the publishers that gracefully provided permission to contribu-
tors to reproduce part or all of their previously published works, we extend our
appreciation and thanks. Where such reproductions have occurred, we include
acknowledgments and thanks at the end of these individual chapters. However, the
editors would like to offer our thanks again here to the publishing houses: Taylor
Francis, Elsevier and Wiley.
Secondly, it is perhaps tautological to point out that without the outstanding work
and contributions of our authors, this book would not exist. To each contributor,
whether a sole or co-author—the editors are proud to be associated with each of you
and want each of you to know that your contributions have elevated the overall aca-
demic quality and clinical utility of this book. Thank you.
Thirdly, to the foreword writers, Françoise and Dan; we greatly appreciate your
Forewords and the endorsement of the book, and both of which offer some thought-
ful and interesting insights and comments.
Fourthly, to the publishing team, Nathalie and Madona, and everyone else at
Springer; we know the effort and energy you put into this book. We hope and trust
that you are happy with the finished product and what a way to start a book series.
Thank you.
Fifthly, to our families, Joao Santos and Rita Santos, and to Maryla, Natalia and
Charlotte—we could not have done this without your unfailing support, love and
encouragement. This one is for you!
And lastly to all the clients, family members and significant others that we have
encountered in our respective mental health care careers; we are honoured to have
shared in your journey and hope that, in some small way, we made a difference for
the better.

xi
Contents

Part I Principles and Approaches

1 Introduction: Remembering the Person: The Need for a
Twenty-First-Century, Person-Centred European
Psychiatric/Mental Health Nursing Textbook ��������������������������������������    3
John R. Cutcliffe and José Carlos Santos
2 Oxymoronic or Synergistic: Deconstructing the Psychiatric
and/or Mental Health Nurse ���������������������������������������������������������������������� 13
John R. Cutcliffe, Chris Stevenson, and Richard Lakeman
3 Service User Involvement and Perspectives���������������������������������������������� 29
Marta Ferraz
4 Taxonomies: Towards a Shared Nomenclature and Language������������   37
Carlos Alberto da Cruz Sequeira and Francisco Miguel Correia
Sampaio
5 Theories of the Interpersonal Relationships, Transitions
and Humanistic Theories: Contribution to Frameworks
of Psychiatric/Mental Health Nursing in Europe���������������������������������   49
José Carlos Carvalho and Raul Alberto Cordeiro
6 An Introduction to the Art and Science of Cognitive
Behavioural Psychotherapy������������������������������������������������������������������������ 59
John Swan and Graham Sloan
7 Psychodynamic and Psychoanalytical Theory, Approaches
and Clinical Relevance: Applying the Psychoanalytic
Principles and Practices to Mental Health Nursing������������������������������   75
J. Lopes and John R. Cutcliffe
8 The Biopsychosocial Approach: Towards Holistic,
Person-Centred Psychiatric/Mental Health Nursing Practice������������   89
José Carlos Santos, Marie Bashaw, Will Mattcham,
John R. Cutcliffe, and Kelly Graziani Giacchero Vedana

xiii
xiv Contents

9 Trauma-Informed Care: Progressive Mental Health Care

for the Twenty-First Century�������������������������������������������������������������������� 103
John R. Cutcliffe, Rodger Travale, and Tyler Green
10 Competences for Clinical Supervision in Psychiatric/Mental
Health Nursing ������������������������������������������������������������������������������������������ 123
John R. Cutcliffe and Graham Sloan
11 European and Worldwide Mental Health Epidemiology
and Trends�������������������������������������������������������������������������������������������������� 141
Evanthia Sakellari
12 Mental Health Nurses and Responding to Suffering
in the Twenty-first Century Occidental World: Accompanying
People on Their Search for Meaning�������������������������������������������������������� 151
John R. Cutcliffe, Jan Kare Hummelvol, Arild Granerud,
and Bengt Erikson

Part II Settings and Contexts

13 Acute Inpatient Psychiatric/Mental Health Nursing: Lessons

Learned and Current Developments�������������������������������������������������������� 169
Roland van de Sande
14 Community Psychiatric/Mental Health Nursing: Contexts
and Challenges—The Case of Nurse Prescribing
and Recovery-­Focused Interventions ���������������������������������������������������� 183
Steve Hemingway and Neil Brimblecombe
15 Unearthing the Theoretical Underpinnings of “Green Care”
in Mental Health and Substance Misuse Care: History,
Theoretical Origins, and Contemporary Clinical Examples ���������������� 195
John R. Cutcliffe and Rodger Travale
16 Nursing People in Prisons, Forensics and Correctional Facilities �������� 211
Tommy Dickinson, Amrita Mullan, Kirsty Lippiatt,
and Julie Ann Owen
17 eHealth, Telematics and Telehealth���������������������������������������������������������� 223
Nina Kilkku
18 Public Health and Ecological Approaches: The Example
of eHealth for Adolescent Mental Health Support �������������������������������� 235
Anttila Minna, Kurki Marjo, and Välimäki Maritta

Part III Psychiatric/Mental Health Nursing Competencies

and Ways of Working
19 Forming and Maintaining Interpersonal Relationships������������������������ 247
Manuel José Lopes
Contents xv

20 Psychiatric/Mental Health Nursing Core Competencies:

Communication Skills�������������������������������������������������������������������������������� 259
Cândida Loureiro, Helena Quaresma, and José Carlos Santos
21 Group Work in Psychiatric/Mental Health Nursing: The Case
for Psychoeducation as a Means to Therapeutic Ends �������������������������� 269
Evelyn Gordon and Maeve Kenny
22 A Family-Focused, Recovery Approach When Working
with Families When a Parent Has a History of Mental Health
Problems: From Theory to Practice�������������������������������������������������������� 283
Darryl Maybery and Andrea Reupert
23 Psychiatric/Mental Health Nursing and Mental Health
Promotion: An Eight Steps Path�������������������������������������������������������������� 293
José Carlos Rodrigues Gomes
24 Therapeutic Milieu: Utilizing the Environment to Promote
Mental Wellness������������������������������������������������������������������������������������������ 309
Tyler D. Green
25 Psychiatric/Mental Health Nursing Nonphysical Competencies
for Managing Violence and Aggression: De-escalation
and Defusion ���������������������������������������������������������������������������������������������� 319
Hulya Bilgin and Zeynep Ozaslan
Part IV Human Experiences of Mental Health Problems and Psychiatric/
Mental Health Nursing Responses

26 Problems Affecting a Person’s Mood ������������������������������������������������������ 337

German López-Cortacans, Carme Ferré-Grau,
and José Carlos Santos
27 The Person Experiencing Anxiety������������������������������������������������������������ 353
Columba McLaughlin
28 Integrated Care – ‘Schizophrenia’: A Challenge
for Psychiatric/Mental Health Nursing���������������������������������������������������� 371
David González-Pando and Fernando Alonso-Pérez
29 Human Experiences of and Psychiatric/Mental Health Nurses’
Responses to Problems Related to Dementias
and Cognitive Impairment������������������������������������������������������������������������ 385
Helena Quaresma, Cândida Loureiro, and José Carlos Santos
30 Problems Related to Substance and Alcohol Misuse������������������������������ 395
Fatma Yasemin Kutlu and Gul Dikec
xvi Contents

Part V Specific Challenges

31 Problems Related to Eating, Nutrition, and Body Image���������������������� 425

Christopher Modica
32 Suicide and Self-Harm������������������������������������������������������������������������������ 441
José Carlos Santos
33 A Systematic Perspective of Violence and Aggression in Mental
Health Care: Toward a More Comprehensive Understanding
and Conceptualization ������������������������������������������������������������������������������ 453
John R. Cutcliffe and Sanaz Riahi
34 The Withdrawn or Recalcitrant Client���������������������������������������������������� 479
Richard Lakeman
35 Confronting Goffman: How Can Mental Health Nurses
Effectively Challenge Stigma? A Critical View of the Literature���������� 493
L. Bates and T. Stickley

Part VI Special Populations

36 Psychiatric/Mental Health Nursing Care of Children

and Adolescents���������������������������������������������������������������������������������������� 507
António Jorge Soares Antunes Nabais, Lucília Rosa Mateus Nunes,
John R. Cutcliffe, and José Carlos Santos
37 Psychiatric/Mental Health Nursing Care of the Older Adult:
Mental Health in Old Age������������������������������������������������������������������������� 521
Bengt Eriksson and Arild Granerud
38 Psychiatric/Mental Health Nurses Care of the Client Who Presents
with Both Mental Health and Substance Misuse Problems ������������������ 533
John R. Cutcliffe, Rodger Travale, and T. Green
39 Non-European and European Migrants in Acute Adult Inpatient
Mental Healthcare: Dissociation and Identity���������������������������������������� 549
Yasmine Souiah-Benchorab, Stephen Adshead,
and Jean-Manuel Morvillers
40 Working with Individuals Who Are Homeless���������������������������������������� 561
Cheryl Forchuk
41 Mental Health Problems and Risks in Refugees During Migration
Processes and Experiences: Literature Overview
and Interventions �������������������������������������������������������������������������������������� 571
Cossu Giulia, Maura Galletta, and Carta Mauro Giovanni
About the Editors

Dr. John R. Cutcliffe is the owner/operator of

Cutcliffe Consulting, a health care/higher educa-
tion/corrections consulting firm that operates in the
USA, Canada, and Europe. He is an esteemed aca-
demic, having held three Endowed Research Chairs;
he also practices as a psychotherapist. He also holds
Adjunct Professor positions at the University of
Ottawa, Canada; the University of Coimbra,
Portugal; and the University of Malta, Malta. Most
recently, John held the ‘Blanke Endowed Research Chair in Nursing Research’/
Director for the Center for Nursing Research at Wright State University, Ohio,
USA. His two previous Endowed Professorial Research chairs were the ‘David
G. Braithwaite Research Chair’ at the University of Texas and the ‘Acadia
Professorship in Psychiatric and Mental Health Nursing’ at the University of
Maine, both in the USA.
John’s clinical background is in nursing, having completed his psychiatric nurse
and then his general nurse education in the United Kingdom. John’s research inter-
ests focus on hope, suicide, and clinical supervision, and he was recognised by the
federal government of Canada and cited as one of the top 20 ‘Research Leaders of
Tomorrow’ for his research focusing on hope and suicidology.
He has published extensively—over 120 peer-reviewed papers, 35 chapters, over
50 professional/editorial/non-peer-reviewed papers, 11 books, and over 90 abstracts/
conference proceedings. As of June 2017, his work has been cited more than 5647
times (according to Google Scholar), his ‘H’ Index is 39; his I-10 index is 100. His
work on suicide and care of the suicidal person has been translated into German,
Japanese, Dutch, Spanish, Mandarin Chinese, Portuguese, Korean, Turkish, and
Italian. He has over $5,000,000 dollars of extra-mural research funding as Primary/
Co-Investigator and his research findings, particularly those pertaining to suicide
and hope, are now found in best practice guidelines in several parts of the world.
John has a track record of successful doctoral student supervision, operationalized
through his primary and Adjunct appointments. As a result, he has a track record of
providing doctoral supervision via distance to his internationally located students.
He has served as the national Canadian Representative for the International
Association of Suicide Prevention and the Director of the International Society of

xvii
xviii About the Editors

Psychiatric Nurses: Education and Research division: he is the Associate Editor for
the highest ranked Psychiatric/Mental Health Nursing Journal as well as serving on
the boards of eight other health or education focused journals. And in 2012 he was
invited by the Director of Medicine at Yale University to join the first international
advisory board on Clinical Supervision.
He retains his interest in clinical work, particularly in psychotherapy and advanc-
ing a more human-focused approach to Psychiatric/Mental Health nursing—in psy-
chiatric facilities, corrections facilities, and substance misuse facilities; care of the
suicidal person, inspiring hope, clinical supervision, and dealing with violence and
aggression.
José Carlos Santos is a Coordinating Professor
at the Nursing School of Coimbra. He has a back-
ground in nursing and experience in general and
psychiatric hospitals. He completed his nurs-
ing degree (1986), mental health specialisation
(1997), and master’s degree (2000) in Coimbra,
and his doctoral degree (2006) at the University
of Porto.
He is a researcher of the Health Sciences
Research Unit: Nursing (UICISA:E), Nursing
School of Coimbra. He coordinates the ‘Prevention
of suicidal behaviours’ project, which has three main
areas: adolescents—prevention of suicidal behav-
iours in schools; families—prevention of suicidal
behaviours with the families; and ­professionals—
guidelines and tools to prevent suicidal behaviours. He is also a researcher at the
Portuguese Observatory on Health Systems.
José is a professor of Mental Health/Psychiatric Nursing in doctoral and master’s
programmes, and in an undergraduate nursing degree. He is currently the coordina-
tor of the master’s degree in Mental Health and Psychiatric Nursing at the Nursing
School of Coimbra.
He is a renowned specialist in suicidal behaviours. He was President of the
Portuguese Society of Suicidology (2011–2013) and Rapporteur for the Portuguese
Suicide Prevention Plan (2013–2020). He supervises both national and international
master’s dissertations and doctoral theses in this field. He also works in the Suicide
Research and Prevention Unit at the Coimbra University Hospital.
José is a member of several health-related organisations where he occupies a
position of responsibility.
He has published extensively in this field. He is the author or coauthor of 5
books, 13 chapters, over 30 peer-reviewed papers, and over 60 abstracts/conference
proceedings in Portuguese and English. He is a board member or referee of several
journals.
His interests focus on suicidal behaviours and their impact on the family, society,
and professionals, liaison psychiatry, and mental health/psychiatric nursing in
general.
Contributors

Stephen Adshead School of Health and Human Sciences, University of Essex

(Southend on Sea), Colchester, UK
Fernando Alonso-Pérez University of Oviedo, Oviedo, Spain
Marie Bashaw Assistant Professor of Nursing, Wright State University, Ohio,
USA
L. Bates Substance Misuse Nurse, Dudley and Walsall Mental Health
Partnership NHS Trust, Dudley, UK
Hulya Bilgin Florence Nightingale Nursing Faculty, Psychiatric and Mental
Health Nursing, Istanbul University, Istanbul, Turkey
Neil Brimblecombe South London and Maudsley NHS Foundation Trust,
London, UK
José Carlos Carvalho Escola Superior de Enfermagem do Porto (Nursing
College of Porto), Porto, Portugal
Raul Alberto Cordeiro Polytechnic Institute of Portalegre, Portalegre, Portugal
Carlos Alberto da Cruz Sequeira Nursing School of Porto, Porto, Portugal
Scientific Pedagogical Unit, “Nursing: Discipline & Profession”, Nursing School
of Porto, Porto, Portugal
Research Group “NursID: Innovation & Development in Nursing” Center for
Health Technology and Services Research (CINTESIS), Porto, Portugal
Portuguese Society of Mental Health Nursing, Porto, Portugal
John R. Cutcliffe Cutcliffe Consulting, Kingston, Canada
School of Nursing, Coimbra, Portugal
Tommy Dickinson The University of Manchester, Manchester, UK
Gul Dikec Nursing Department, Health Science Faculty, Istinye University,
Istanbul, Turkey

xix
xx Contributors

Bengt Eriksson Inland Norway University of Applied Science, Faculty of

Public Health, Hedmark University College, Elverum, Norway
Marta Ferraz Coordinator of the Advisory Commission for User and Caregiver
Participation, National Mental Health Programme, DGS, Director of the Oeiras
Psychosocial Rehabilitation Unit, ARIA, Mira, Portugal
Carme Ferré-Grau Department of Nursing, Rovira i Virgili University,
Tarragona, Spain
Cheryl Forchuk Western University, London, ON, Canada
Maura Galletta Department of Medical Science and Public Health, University
of Cagliari, Cagliari, Italy
Kelly Graziani Giacchero Vedana Ribeirão Preto College of Nursing - PAHO/
WHO Collaborating Centre for Nursing Research Development, University of
São Paulo, Butantã, Brazil
Carta Mauro Giovanni Department of Medical Science and Public Health,
University of Cagliari, Cagliari, Italy
Cossu Giulia Department of Medical Science and Public Health, University of
Cagliari, Cagliari, Italy
José Carlos Rodrigues Gomes Health Research Unit, School of health
Sciences, Polytechnic Institute of Leiria, Leiria, Portugal
David González-Pando University of Oviedo, Oviedo, Spain
Amrita Goomany Sheffield Health & Social Care NHS Foundation Trust,
Sheffield, UK
Evelyn Gordon School of Nursing and Human Sciences, Dublin City
University, Dublin, Ireland
Arild Granerud Inland Norway University of Applied Science, Faculty of
Public Health, Hedmark University College, Elverum, Norway
Tyler Green Clinical Instructor and Psychiatric Nurse Practitioner, Wright State
University Ohio, New York, NY, USA
Tyler D. Green College of Nursing and Health, Wright State University,
Dayton, OH, USA
T. Green Owner/Operator Cutcliffe Consulting, University of Coimbra, Dayton,
Portugal
Steve Hemingway University of Huddersfield, Huddersfield, UK
Jan Kare Hummelvol Inland Norway University of Applied Science, Faculty of
Public Health, Hedmark University College, Elverum, Norway