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The purpose of this paper is to review policy or guidance on the implementation of Section 5(4) written by NHS mental health trusts in England and health boards in Wales.

A Freedom of Information request was submitted to all trusts in England (n=57) and health boards in Wales (n=7) asking them to provide a copy of any policy or guidance on the implementation of Section 5(4). Documents were analysed using content analysis. Specific attention was given to any deviations from the national Mental Health Act Codes of Practice.

In total, 41 (67.2 per cent) organisations had a policy on the implementation of Section 5(4). There was a high level of consistency between local guidance and the Mental Health Act Codes of Practice. There were however; different interpretations of the guidance and errors that could lead to misuse of the section. Some policies contained useful guidance that could be adopted by future versions of the national Codes of Practice.

The research has demonstrated the value of examining the relationship between national and local guidance. Further research should be undertaken on the frequency and reasons for any reuse of the section.

Greater attention should be given to considering the necessity of local policy, given the existence of national Codes of Practice.

This is the only research examining the policy framework for the implementation of Section 5(4).

The purpose of this paper is to determine what written information is given to informally admitted patients in England and Wales regarding their legal rights in relation to freedom of movement and treatment.

Information leaflets were obtained by a search of all National Health Service mental health trust websites in England and health boards in Wales and via a Freedom of Information Act 2000 request. Data were analysed using content analysis.

Of the 61 organisations providing inpatient care, 27 provided written information in the form of a leaflet. Six provided public access to the information leaflets via their website prior to admission. Although the majority of leaflets were accurate the breadth and depth of the information varied considerably. Despite a common legal background there was confusion and inconsistency in the use of the terms informal and voluntary as well as inconsistency regarding freedom of movement, the right to refuse treatment and discharge against medical advice.

The research has demonstrated the value of Freedom of Information Act 2000 requests in obtaining data. Further research should explore the effectiveness of informing patients of their rights from their perspective.

Work should be undertaken to establish a consensus of good practice in this area. Information should be consistent, accurate and understandable.

This is the only research reporting on the availability and content of written information given to informal patients about their legal rights.

Mental health and learning disability nurses have been eligible to become approved mental health professionals (AMHPs) since 2008, when the Mental Health Act 2007 was implemented. Despite this, there have been proportionally low numbers of these nurses pursuing the AMHP role. The purpose of this paper is to explore the experiences of these nurse AMHPs of training and practice.

Ten practicing nurse AMHPs were recruited from across four local authority sites. Using semi-structured interviews, participants were asked to discuss their experiences of being an AMHP.

The participants highlighted the need to navigate personal, cultural and structural factors relating to accessing and applying for the training, difficulties with agreeing contracts terms, gaining comparative pay and undertaking the role.

The limitations of this study are the small number of participants and therefore the generalisability of the findings. Also, respondents were practising AMHPs rather than nurses who considered the role but then rejected it as a career option.

This study has led to gain a greater understanding of the experiences of nurse AMHPs.

The results from this study will assist employing local authorities, and NHS consider the barriers to mental health and learning disability nurses becoming AMHPs.

The value of this study is in the insight that provides the experiences of nurse AMHP from applying to training through to being a practising AMHP.

The purpose of this paper is to report on the use and content of written guidance produced by mental health services in England and Wales describing hospital leave for informally admitted patients.

Guidance on leave was requested from National Health Service (NHS) mental health trusts in England and health boards in Wales (n = 61) using a Freedom of Information submission. Data were analysed using content analysis.

In total, 32 organisations had a leave policy for informal patients. Policies varied considerably in content and quality. The content of policies was not supported by research evidence. Organisations appeared to have developed their policies by either adapting or copying the guidance on section 17 leave outlined in the Mental Health Act Codes of Practice for England and Wales (Department of Health, 2016; Welsh Government, 2016). Definitions of important terms, for example, leave and hospital premises, were either absent or poorly defined. Finally, some organisations appeared to be operating pseudo-legal coercive contracts to prevent informal patients from leaving hospital wards.

Research should be undertaken to explore the impact of local policies on the informal patient’s right to life and liberty.

All NHS organisations need to develop an evidence-based policy to facilitate the informal patient’s right to take leave. A set of national standards that organisations are required to comply with would help to standardise the content of leave policies.

To the best of the author’s knowledge, this is the first study to examine the use and content of local policies describing how informal patients can take leave from hospital.

Sets out to report on an exploratory study in which perspectives on cross‐cultural counselling in mental health care in Auckland, New Zealand, are to be examined.

The study utilised a single questionnaire which sought mental health professionals' perceptions on issues and concepts of cross‐cultural counselling. The questionnaire was administered in the nine public psychiatric units in Auckland.

Apart from the health units providing bicultural (European and Maori) counselling services, there was little cross‐cultural counselling available to an increasingly multicultural community.

With regard to the need for cross‐cultural counselling, rather than address the issue of population change this study examines the effect that lack of diversity would have on the gains that would otherwise be made in the health‐care system of Auckland, New Zealand.

Staff must have an appreciation of legal and ethical issues associated with the people they care for, particularly when physical restraint to manage aggression or violence is being considered. This article examines legal and ethical issues related to the management of aggression and violence, and considers the inclusion of this material in training courses.

The purpose of this paper is to use generational cohort and professionalism theories as the framework to examine the interaction between supervisor‐subordinate relationships, work‐family conflict, discretionary power and affective commitment at the work‐life interface for Northeast Brazilian public sector professional nurses.

Quantitative data were collected from 550 public hospital nurses in North‐Eastern Brazil. Path and multivariate analysis were used to test the hypotheses.

The findings demonstrate that the impact of the independent variables on affective commitment was statistically significant but low. The impact of NPM factors such as contracting out and multiple job‐holding was a major influence on affective commitment and work‐life interface across generational cohorts. The analysis revealed significant differences between generational cohorts and suggested that affective commitment may well be enhanced by improving the quality of the work‐life interface and consequently, the wellbeing of nurses.

This study is confined to the Northeast of Brazil and confined to public sector hospitals. The self‐reporting techniques used in this study to gather information may be open to common method bias.

The contribution of this research includes the provision of new information about the working context of professional nurses in Brazil, which is a fast growing BRICS economy where the issues surrounding the practice of nursing and nurse management are not well studied to date (i.e. NPM impact on nurse environment). North‐eastern Brazilian managers need to be more aware of generational differences and their impact on levels of affective commitment and the quality of the work‐life interface and wellbeing.

The purpose of this study is to describe and explore from the perspectives of top‐level nurses holding the formal position of director of nursing their perceptions and interpretations of their experiences in the Irish healthcare system.

This paper presents some findings from a nation‐wide study, which is qualitative in approach using grounded theory methodology. Semi‐structured interviews were conducted with 50 directors of nursing representing general and psychiatric nursing.

The study in this paper was conducted in the context of a changing healthcare system, which emphasises the flattening of organisational pyramids. However, this study's findings indicate that, while structures might be changing, behaviours remain unaltered. In particular, the medicine nursing power base remains unchanged, while the power shift between nursing and general management continues to widen in favour of general management.

Research in this paper shows that directors of nursing who chose to participate in this study may have different perceptions of experiences from those who chose not to participate.

In the paper the reality is neither medicine nor general management, individually or collectively, are going to share or devolve power and influence to nursing. This study's findings indicate that nursing needs to confront this power imbalance. Nursing needs to take the first steps towards shattering the glass ceiling by really examining its own behaviours, in maintaining the status quo, in the traditional balance of power.

The purpose of this paper is to explore and describe online communication about the experiences and attitudes toward Swedish Healthcare Direct, a national telephone advice nursing (TAN) service.

A descriptive research design was adopted using a six-step netnographic method. Three Swedish forums were purposefully selected and data from the virtual discussions were collected.

Three themes emerged: expectancy and performativity of the nurses, absurdity in accessibility and the scrutinizing game. The most prominent finding was the scrutinizing game, which included aspects of bidirectional mistrust from both nurses and callers. Another salient finding was the attitudes that callers held toward nurses who used a technique interpreted as “passing the buck.”

The use of a nethnographic method is novel in this area of research. Consequently, the body of knowledge has regarding telephone advise nursing service has significantly been broadened. A limitation in this study is that demographic data for the posters are not available.

Bidirectional distrust is an important issue that must be acknowledged by TAN services, since it might damage the service on a fundamental level. Healthcare providers, politicians, and researchers should account for the power and availability of virtual discussions when seeking consumers’ opinions and evaluating the quality of the care provided.

This analysis of the ongoing discussions that take place on the internet provides insight into callers’ perceptions of a national TAN service. The bidirectional mistrust found from both the nurses and the callers might be a threat to callers’ compliance with the advice given and their care-seeking behavior.