Tag: Palestine

New year

Happy new year. In December 2017, I was pleased to see Values in Health and Social Care: an Introductory Workbook published, co-written with Ray Samuriwo, Stephen Pattison and Andrew Todd. It is a product of the Cardiff Values group, which began life over 15 years ago, and is the third book of its type that I’ve been involved in. The first was Values in Professional Practice: Lessons for Health, Social Care and other Professionals and the second was Emerging Values in Health Care: the Challenge for Professionals. This latest outing is very hands-on, and is packed with exercises for students and their teachers. I hope people find it stimulating and useful.

SamudIn previous posts (see here and here) I’ve written about Mohammad Marie’s PhD, which investigated resilience in Palestinian community mental health nurses. A fourth paper derived from this study has just been assigned to the January 2018 issue of the journal Health. This is a review of literature, and addresses (amongst other things) the connections between resilience and the idea of ‘Samud’. By following this link a gold open access version of the paper can be downloaded for free.

Elsewhere, I realise I have neglected to add any recent updates on this site about the work of Mental Health Nurse Academics UK. Last year was an active one. In addition to our usual three meetings we exercised our responsibilities as a Research Excellence Framework nominating body, and responded to a variety of consultations and calls for evidence: a nursing workforce inquiry initiated by the House of Commons Health Select Committee; the Nursing and Midwifery Council‘s proposed standards for education; both NHS Improvement and Centre for Mental Health reports on the mental health workforce; and more besides. Our meetings for this year are all scheduled, and it will be good to catch up in Birmingham in February, Greenwich in June and Essex in October.

 

 

Out with the old

Happy new year. In one of my earliest posts on this blog I wrote of coming across a fallen tree. Over the months and years following this became something of a local landmark for those of us fond of making the trip over Craig yr Allt by foot. The tree was removed sometime last autumn, with tyre tracks telling a tale. I’ll add its disappearance to the long list of last year’s losses, included on which are Carrie Fisher, George Michael and the security of Britain remaining in the EU.

2016-10-28-08-40-23

If 2016 had more than its fair share of trampling, and like the track up Craig yr Allt bowed out with its topsoil removed, perhaps this year will be different. Or maybe not. Anyway…

As 2017 gets underway I’ve opened my term of office as Vice Chair of Mental Health Nurse Academics UK with a fruitful conversation with Steven Pryjmachuk, the group’s Chair for this year and next. Ideas for refreshing the MHNAUK website, and our March meeting at the University of Hertfordshire, were amongst things on the agenda. We’ll have lots to talk about; as I observed in my last post, a number of important things are afoot with likely changes to the education of nurses and the beginnings of plans being laid for the next research excellence framework.

Elsewhere, the forthcoming care planning and care coordination themed issue of the Journal of Psychiatric and Mental Health Nursing which Michael Coffey, Alan Simpson and I are guest editing is taking shape nicely. We have some super articles lined up, and will be writing editorials in the near future.

Later in the year, in September, the newly renamed International Mental Health Nursing Research Conference (the NPNR, as was) meets in Cardiff. I’ll be off to a conference planning meeting in London in a week’s time where we’ll be talking about a theme for #MHNR2017 and possible keynote speakers. I’ll perhaps blog something about that when we’re done.

marie-et-al-2017On the publications front, Mohammad Marie has lead authored (with Aled Jones and me in support) this latest paper. It’s all about the challenges faced by Palestinian community mental health nurses, and represents the fourth article emerging from Mohammad’s PhD thesis in something like 18 months. That’s good going indeed. Here’s the abstract:

Background:
Nurses in Palestine (occupied Palestinian territory) work in a significantly challenging environment. The mental health care system is underdeveloped and under-resourced. For example, the total number of nurses who work in community mental health centres in the West Bank is seventeen, clearly insufficient in a total population of approximately three million. This research explored daily challenges that Palestinian community mental health nurses (CMHNs) face within and outside their demanding workplaces.
Methods:
An interpretive qualitative design was chosen. Face-to-face interviews were completed with fifteen participants. Thirty-two hours of observations of the day-to-day working environment and workplace routines were conducted in two communities’ mental health centres. Written documents relating to practical job-related policies were also collected from various workplaces. Thematic analysis was used across all data sources resulting in four main themes, which describe the challenges faced by CMHNs.
Results and conclusion:
These themes consist of the context of unrest, stigma, lack of resources, and organisational or mental health system challenges. The study concludes with a better understanding of challenges in nursing which draws on wider cultural contexts and resilience. The outcomes from this study can be used to decrease the challenges for health professionals and enhance the mental health care system in Palestine.

 

Resilience of community mental health nurses in Palestine

Earlier this week a new article lead authored by Mohammad Marie, and co-authored by Aled Jones and me, was published in the International Journal of Mental Health Nursing. The title of the article is Resilience of nurses who work in community mental
health workplaces in Palestine
, and is the second paper arising from Mohammad’s completed PhD. As the article appears in gold open access form copies can be directly downloaded from the journal’s website for free: or indeed, by clicking either the hyperlinked title or image above.

The larger part of Mohammad’s qualitative dataset is interviews conducted with CMHNs working in the West Bank. Fifteen practitioners took part, from a total population of 17. For the record, that’s 17 community mental health nurses for a population of some three million people. That’s an astonishingly low number by UK standards; for more on mental health needs and services in Palestine, the place to go is Mohammad’s first paper (Mental health needs and services in the West Bank, Palestine) about which I previously blogged here.

Here is the abstract from this latest paper:

People in Palestine live and work in a significantly challenging environment. As a result of these challenges they have developed resilient responses which are embedded in their cultural context. ‘Sumud’, in particular, is a socio-political concept which refers to ways of surviving in the context of occupation, chronic adversity, lack of resources and limited infrastructure. Nurses’ work in Palestine is an under-researched subject and very little is known about how nurses adjust to such challenging environments. To address this gap in the literature this study aimed to explore the resilience of community mental health nurses (CMHNs) who work in Palestine. An interpretive qualitative design was chosen. Fifteen face-to-face interviews were completed with participants. Thirty-two hours of observations of the day-to-day working environment and workplace routines were conducted in two communities’ mental health centres. Written documents relating to practical job-related policies were also collected from various workplaces. Thematic analysis was used across all data sources resulting in four main themes, which describe the sources of resilience among CMHNs. These sources are ‘Sumud and Islamic cultures’, ‘Supportive relationships’, ‘Making use of the available resources’, and ‘Personal capacity’. The study concludes with a better understanding of resilience in nursing, which draws on wider cultural contexts and social ecological responses. The outcomes from this study will be used to develop the resilience of CMHNs in Palestine.

The idea of ‘Samud’ which is referred to above is an important one in Mohammad’s work, and (as I have learned) for Palestinian people. Drawing on the work of Toine Van Teeffelen, here is what Mohammad says about it in his thesis:

[Samud] is the art of living to survive and thrive on their homeland in spite of hardship and under occupation practices. These skills of how to live are used in different aspects of life such as economic, political and social. They can also be used at many levels: individual, family and within the Palestinian community. Moreover, Sumud has been divided into two types: tangible resources such as the infrastructure supporting basic needs (for example, schools and hospitals) which enable the existence of the Palestinians on their land and help them to be more resilient. In addition intangible sources of Sumud also exist, which include: belief systems, religion and social and family support which help the Palestinians to cope with their chronic daily collective suffering.

For Mohammad, Samud is closely related to the more familiar (to me, at any rate) idea of resilience. Or, more properly put, Samud connects to social ecological variants of resilience which place as much emphasis on the social and cultural as they do on the individual.

I’ll stop here and leave people to download and read this new paper for themselves. For those interested, Mohammad, Aled and I are working on further publications from this doctorate: so more will follow in due course.

Mental health needs and services in Palestine

Mohammad Marie, Aled Jones and I have co-authored a paper arising from Mohammad’s PhD. This appears in the gold open access International Journal of Mental Health Systems, and a copy can be downloaded by following this link.

The article is titled Mental health needs and services in the West Bank, Palestine and has this for an abstract:

Background: Palestine is a low income country with scarce resources, which is seeking independence. This paper discusses the high levels of mental health need found amongst Palestinian people, and examines services, education and research in this area with particular attention paid to the West Bank.
Methods: CINAHL, PubMed, and Science Direct were used to search for materials.
Results and conclusion: Evidence from this review is that there is a necessity to increase the availability and quality of mental health care. Mental health policy and services in Palestine need development in order to better meet the needs of service users and professionals. It is essential to raise awareness of mental health and increase the integration of mental health services with other areas of health care. Civilians need their basic human needs met, including having freedom of movement and seeing an end to the occupation. There is a need to enhance the resilience and
capacity of community mental health teams. There is a need to increase resources and offer more support, up-to-date training and supervision to mental health teams.

Further papers from Mohammad’s study will follow, and I’ll aim to post updates as work progresses.

Resilience and community mental health nursing in Palestine

With his permission, let me introduce you to Mohammad Marie. I know Mohammad as a PhD student in the Cardiff School of Nursing and Midwifery Studies. He is also a mental health nurse and teacher, who (when he isn’t attending to his thesis in south Wales) works at An-Najah National University in Nablus, in the Palestinian West Bank.

Mohammad is interested in resilience, both generally and in community mental health nurses in particular. Through his writing I have gained a glimpse of mental health needs and services in the occupied Palestinian territories, and of the day-to-day realities of living and providing health care in this part of the world. Quite rightly, nurses in the UK complain about lacking resources, of coping with high caseloads and of the dangers of burnout. Here, however, we can barely comprehend the enormity of the challenge facing those who do nursing in Palestine. Human rights are violated, and free movement restricted. Access to medicines is limited, and rates of trauma and mental ill-health high. Few practitioners have had opportunities to develop knowledge and skills specific to the provision of mental health care. For readers wanting to know more, the World Health Organization has made available information on health and health services in Palestine here.

A simple question drives Mohammad’s study: given their circumstances, what are the sources of resilience which help community mental health nurses continue in their caring work? As part of laying out the background to his project Mohammad has introduced me to the uniquely Palestinian concept of ‘samud’. ‘Samud’ and ‘resilience’ look, to me, to be close cousins, with the former referring to steadfastness in the face of adversity. It manifests in individual and social action, as well as in specific policy (for example, to support the development of an infrastructure for public services). From what Mohammad tells me, samud has become an important part of Palestinian culture and identity.

To get answers to his research question, Mohammad returned home last year to generate data. In ethnographic style he observed nurses and other staff going about their day-to-day tasks, basing himself in a series of government and non-governmental community mental health centres. He read local documents relating to the organisation of services. In order to explore nurses’ experiences and views in depth, Mohammad conducted detailed interviews with a sample of practitioners. The absolute number of participants in this phase was modest, but still a majority of the total population of community mental health nurses working in the West Bank.

Right now Mohammad is surrounded by transcripts and notes, doing his best to make sense of everything he has seen, read and heard. It’s for him to tell the story of his findings, but I know these will be both interesting and important. I’m looking forward.