Dan Warrender

Social media has become a mainstay of popular culture, with a growing number of users. Yet the understanding of how social media can impact on mental health is at an early stage. This article focuses on social media and how the increased opportunity to make social comparison may contribute to mental health difficulties. Relevant theory and clinical examples are discussed. Suggestions are made for nursing practice.

The causation of mental health problems remains burdened with an uncertainty which freely allows a variety of assertions to be made (Pilgrim 2014). It is therefore crucial, in this arena of confusion, that some sense be available. This chapter will bring together sociology, spirituality and philosophy, and describe the human need to seek meaning, arguing the crucial role of spirituality in making sense of mental distress. The concepts of death and dying will be explored with a view to introducing spirituality, before arguments are applied specifically to mental health and the professional’s role in spiritual care.

Self-disclosure can be valuable in therapeutic relationships, although practitioners may feel apprehension around boundaries and worry what may be appropriate. This article asserts the importance of critical thinking around self-disclosure, emphasising that while there is no clear ‘right and wrong’, what is necessary in professional practice is to carefully consider its purposeful use. Discussion using evidence and clinical examples is framed within a model that may be used to aid reflection on the use of self-disclosure within the therapeutic relationship. Self-disclosure is a grey area, but its use in mental health nursing can be invaluable.

Patients with borderline personality disorder are frequent users of inpatient mental health units, with inpatient crisis intervention often used based on the risk of suicide. However, this can present an ethical dilemma for nursing and medical staff, with these clinician responses shifting between the moral principles of beneficence and non-maleficence, dependent on the outcomes of the actions of containing or tolerating risk. This article examines the use of crisis intervention through moral duties, intentions and consequences, culminating in an action/consequence model of risk management, used to explore potential outcomes. This model may be useful in measuring adherence and violation of the principles of beneficence and non-maleficence and therefore an aid to clinical decision making.