Collaboration Between People Admitted to Acute Mental Health Units, Their Family Members and Nurses in the Detection of Mental State Changes and Recovery: A Qualitative Systematic Review.

Mental health nurses can engage with people with mental health challenges and their families due to their presence on acute mental health units. This presence helps to facilitate recovery-focused care within a physically and emotionally safe environment. Mental health care should be person-centred, individualised, and include wherever possible family and other people in the person's support network. The objective of this systematic review was to explore the existing qualitative literature that describes experiences of collaboration between people with lived experience of mental health challenges, their family members, and nurses in relation to changes in mental state during an admission to an acute mental health unit. Qualitative systematic review. The Joanna Briggs Institute methodology for systematic reviews of qualitative evidence was followed, including the JBI quality appraisal checklist. The databases searched were CINAHL, Medline, Scopus, Emcare and PsycInfo. Included articles were written in English and published between January 2013 and September 2023. Data was extracted that provided the perspectives of adults (18-64 years), their family members and nurses (collectively known as the "Triangle of Care") regarding communication when mental state changes during an acute mental health admission to a public hospital. Perspectives of the three groups were explored separately then synthesised. The ConQual approach was used to assess confidence in the findings. This review included articles on the lived experience perspective (n = 17), the family perspective (n = 1), and the nurse perspective (n = 13). The identified articles presented common perspectives on how to facilitate person-first nursing care that is supportive of personal recovery, including the provision of one-to-one discussions and inviting input from family members. Nurses, in particular, highlighted systemic barriers and facilitators to the focus on personal recovery in clinical practice. Communication between the three members of the "Triangle of Care" is essential for the identification of mental state changes as a critical aspect of providing nursing care that promotes personal recovery. All three members of the "Triangle of Care" highlighted the importance of making time for one-on-one conversations, which are impacted by other factors such as competing demands on time and confidentiality. Further research is indicated to improve clinical practice and service provision, with extant research being particularly sparse in non-Western and non-English speaking regions. Literature Review Protocol: Prospero registration number: CRD420250639443.