Providing mental health care to involuntary mental health care users (MHCUs) is challenging and an ethical adversity nurses often have to deal with. The literature, in general, indicates that nurses might possess coping and resiliency in the work environment where they are often faced with adversities. However there is a paucity of information regarding the resilience of nurses providing mental health care (MHC) to involuntary MHCUs. Therefore the research objectives explored the resilience of nurses using the Connor-Davidson scale (CD-RISC), to explore and describe how nurses cope and strengthen their resilience in providing MHC to involuntary MHCUs and to formulate guidelines to strengthen the resilience of these nurses to provide quality nursing care in the work environment where MHCUs are often involuntarily admitted. To achieve these objectives, the research followed both a qualitative and quantitative approach and an exploratory and descriptive design which was contextual in nature. A convenience sampling method was used to achieve a sample size of 28 participants, who were handed questionnaires to complete, containing demographical information, the CD-RISC and a narrative. A response rate of 85.7% was reached. Quantitative data was analysed by using the SPSS programme while data from narratives, for the qualitative data, were grouped and themed. The results in the first phase indicated that resiliency was high amongst participants, as the mean score of the CD-RISC was 79.9 out of a total score of 100; whilst only one participant scored below 50. The mean for the highest scores was on item 25 (pride in your achievements) (3.8) and item 10 (best effort no matter what) (3.6) and two critical aspects which scored low were item 18 (make unpopular or difficult decisions) and item 19 (can handle unpopular feelings) (2.3) amongst participants. Interestingly, the majority of participants (66.7%) do not have training in psychiatric nursing. In the second phase, two themes were identified from the questions. The first theme “Coping mechanisms” identified four methods to cope with involuntary MHCUs. These subthemes are “support system”, “knowledge, skills and experience”, “nurse-patient relationship” and “spirituality and selfcare”. The second theme “Resilience strategies” brought forth five subthemes as follows: “support”, “trained staff”, “security measures and safety”, “teamwork” and “in-service training and education”. Conclusions suggest that nurses are resilient to provide MHC for involuntary MHCUs. Furthermore, they take pride in their achievements and have passion for their work. On the contrary, they find it difficult to make unpopular decisions which affect others and to handle unpleasant feelings. This is indicative of internal conflict and difficulty in being assertive. Nurses take pride in their achievements and want to give nursing care that’s in the best interest of the MHCUs whilst they feel that they might not always be able to do so due to the involuntary nature of the MHCUs admission and treatment. Recommendations for nursing practice, namely guidelines to strengthen the resilience of nurses providing mental health care to involuntary MHCUs could be developed from the research findings. Facilitating assertiveness and a supportive environment might strengthen resilience and should be addressed by management and supervisors. Recommendations for nursing education and further research were also formulated. / MCur, North-West University, Potchefstroom Campus, 2015

Providing mental health care to involuntary mental health care users (MHCUs) is challenging and an ethical adversity nurses often have to deal with. The literature, in general, indicates that nurses might possess coping and resiliency in the work environment where they are often faced with adversities. However there is a paucity of information regarding the resilience of nurses providing mental health care (MHC) to involuntary MHCUs. Therefore the research objectives explored the resilience of nurses using the Connor-Davidson scale (CD-RISC), to explore and describe how nurses cope and strengthen their resilience in providing MHC to involuntary MHCUs and to formulate guidelines to strengthen the resilience of these nurses to provide quality nursing care in the work environment where MHCUs are often involuntarily admitted. To achieve these objectives, the research followed both a qualitative and quantitative approach and an exploratory and descriptive design which was contextual in nature. A convenience sampling method was used to achieve a sample size of 28 participants, who were handed questionnaires to complete, containing demographical information, the CD-RISC and a narrative. A response rate of 85.7% was reached. Quantitative data was analysed by using the SPSS programme while data from narratives, for the qualitative data, were grouped and themed. The results in the first phase indicated that resiliency was high amongst participants, as the mean score of the CD-RISC was 79.9 out of a total score of 100; whilst only one participant scored below 50. The mean for the highest scores was on item 25 (pride in your achievements) (3.8) and item 10 (best effort no matter what) (3.6) and two critical aspects which scored low were item 18 (make unpopular or difficult decisions) and item 19 (can handle unpopular feelings) (2.3) amongst participants. Interestingly, the majority of participants (66.7%) do not have training in psychiatric nursing. In the second phase, two themes were identified from the questions. The first theme “Coping mechanisms” identified four methods to cope with involuntary MHCUs. These subthemes are “support system”, “knowledge, skills and experience”, “nurse-patient relationship” and “spirituality and selfcare”. The second theme “Resilience strategies” brought forth five subthemes as follows: “support”, “trained staff”, “security measures and safety”, “teamwork” and “in-service training and education”. Conclusions suggest that nurses are resilient to provide MHC for involuntary MHCUs. Furthermore, they take pride in their achievements and have passion for their work. On the contrary, they find it difficult to make unpopular decisions which affect others and to handle unpleasant feelings. This is indicative of internal conflict and difficulty in being assertive. Nurses take pride in their achievements and want to give nursing care that’s in the best interest of the MHCUs whilst they feel that they might not always be able to do so due to the involuntary nature of the MHCUs admission and treatment. Recommendations for nursing practice, namely guidelines to strengthen the resilience of nurses providing mental health care to involuntary MHCUs could be developed from the research findings. Facilitating assertiveness and a supportive environment might strengthen resilience and should be addressed by management and supervisors. Recommendations for nursing education and further research were also formulated. / MCur, North-West University, Potchefstroom Campus, 2015

Registered counsellors were regarded as part of the solution to the ever-increasing void in mental healthcare and were acknowledged by the South African government over a decade ago. Some challenges have however arisen regarding the implementing of their vocations in the community, that impact service delivery as well as career satisfaction of registered counsellors, but limited information is available in terms of the exploration of the perceptions of registered counsellors regarding their role in the South African context. This study focused on exploring how registered counsellors perceive their role in South Africa and describing these perceptions. This research is important because little is known about the perceptions of registered counsellors and their experience of their role in the South African context. The research was conducted in Johannesburg and Kwa-Zulu Natal, South Africa. 12 participants (one man and 11 women) volunteered to be part of the research. The size of the sample was not predetermined, but was rather based on data saturation. The participants were purposefully selected on the basis of having acquired the registration of registered counsellor with the Health Professions Council of South Africa (HPCSA). Data was collected through conducting semi-structured interviews with all the participants. An interview schedule was used to facilitate the interview process for consistency in the interviews. Thematic analysis was utilised to delineate different themes. To ensure the trustworthiness of the research process, the guidelines suggested by Lincoln and Guba (1985) were followed. The current researcher found that the registered counsellors experienced conflicting perceptions of their role in South Africa. They felt that their role was a necessary and important one in South Africa and in the context of the development of mental healthcare in South Africa. However, some negative feelings were also expressed as they experienced uncertainty regarding their role in the profession as well as the changing scope of practice for registered counsellors in South Africa. Additional negative perceptions were associated with a lack of acknowledgement of their role by other mental healthcare professionals and some ignorance from the public regarding the work of registered counsellors. To promote adequate mental healthcare in South Africa, mental health professionals such as registered counsellors are particularly important. But what appears to be the uncertainty and a lack of information related to the role of registered counsellors, has impacted negatively on their perception of their role in South Africa and, as a result, many individuals do not work in the professional mental healthcare field. It is recommended that the perception of the registered counsellors be acknowledged and taken into consideration to further the development of mental healthcare and treatment for mental health difficulties within the South African context. / MA (Psychology), North-West University, Potchefstroom Campus, 2014

Registered counsellors were regarded as part of the solution to the ever-increasing void in mental healthcare and were acknowledged by the South African government over a decade ago. Some challenges have however arisen regarding the implementing of their vocations in the community, that impact service delivery as well as career satisfaction of registered counsellors, but limited information is available in terms of the exploration of the perceptions of registered counsellors regarding their role in the South African context. This study focused on exploring how registered counsellors perceive their role in South Africa and describing these perceptions. This research is important because little is known about the perceptions of registered counsellors and their experience of their role in the South African context. The research was conducted in Johannesburg and Kwa-Zulu Natal, South Africa. 12 participants (one man and 11 women) volunteered to be part of the research. The size of the sample was not predetermined, but was rather based on data saturation. The participants were purposefully selected on the basis of having acquired the registration of registered counsellor with the Health Professions Council of South Africa (HPCSA). Data was collected through conducting semi-structured interviews with all the participants. An interview schedule was used to facilitate the interview process for consistency in the interviews. Thematic analysis was utilised to delineate different themes. To ensure the trustworthiness of the research process, the guidelines suggested by Lincoln and Guba (1985) were followed. The current researcher found that the registered counsellors experienced conflicting perceptions of their role in South Africa. They felt that their role was a necessary and important one in South Africa and in the context of the development of mental healthcare in South Africa. However, some negative feelings were also expressed as they experienced uncertainty regarding their role in the profession as well as the changing scope of practice for registered counsellors in South Africa. Additional negative perceptions were associated with a lack of acknowledgement of their role by other mental healthcare professionals and some ignorance from the public regarding the work of registered counsellors. To promote adequate mental healthcare in South Africa, mental health professionals such as registered counsellors are particularly important. But what appears to be the uncertainty and a lack of information related to the role of registered counsellors, has impacted negatively on their perception of their role in South Africa and, as a result, many individuals do not work in the professional mental healthcare field. It is recommended that the perception of the registered counsellors be acknowledged and taken into consideration to further the development of mental healthcare and treatment for mental health difficulties within the South African context. / MA (Psychology), North-West University, Potchefstroom Campus, 2014