Mental health care is based on the encounter between the user and the professional, where qualities that lead to relief and improvement can be created. The meeting takes place in, and is influenced by, its context, that is, its local community and society at large. This chapter is based on the structural perspective and the development towards a risk society, which is characterised by new threats, risks and uncertainties. Terrorist acts and environmental threats are examples of such man-made activities. In combination with individualisation and increased dependence on communication technology, they lead to increased demands on the individual and a greater dependence on experts. This is especially true for people with mental health problems. To meet this situation of growing uncertainty and greater individual responsibility, mental health-care needs to develop working methods that go beyond the traditional biomedical perspective. Shared decision-making and collaboration planning are examples of such methods inspired by a person-centred and recovery-oriented perspective. Building durable relationships based on trust and confidence is crucial to successful mental health care. 

In previous studies, social context and social support have been found to be important in nature-based services. However, no studies have previously focused on the meaning of different dimensions of social support in these contexts. The aim of this study is therefore to uncover dimensions of social support in relation to mental health among young adults with mental health problems participating in nature-based services in Norway. This study applies data from a survey of 93 young adults participating in nature-based services; in addition, qualitative interview data from 20 interviews are also used. The data are analysed using qualitative content analysis, descriptive statistics, and correlation analysis. The results indicate that participants in nature-based services experience emotional, esteem, informational, and instrumental support in addition to social integration and opportunities for nurturance in these services. The service leader, other participants, and the animals are important contributors to these dimensions of social support. Nature-based services may be a helpful intervention for young adults with mental health problems. The unique context of these services, including nature and animals, adds special qualities to mental health and social work practices.

Young adults with mental health problems who do not attend school or work constitute a significant welfare challenge in Norway. The welfare services available to these individuals include nature-based services, which are primarily located on farms and integrate the natural and agricultural environment into their daily activities. The aim of this study is to examine young adults (16–30 years old) not attending school or work who participated in nature-based services in Norway. In particular, the study analyses mental health problems among the participants and in-group variations regarding their symptoms of mental health problems using the Hopkins Symptoms Checklist (HSCL-10). This paper compares symptoms of mental health problems among participants in nature-based services with those of a sample from the general population and a sample of those receiving clinical in-patient mental healthcare. A questionnaire was developed for the study and was completed by 93 participants in nature-based services. The majority of these participants were recruited from the Norwegian Labour and Welfare Administration (NAV), local mental health services, and school authorities. Results indicate that just more than half of the respondents exhibited symptoms of mental health problems based on their HSCL-10 scores. In general, they reported fewer symptoms than the clinical in-patient sample (18–30 years old) and more symptoms than the general population sample (18–19 years old). Among the participants in nature-based services, those recruited through NAV and local mental health services exhibited no differences in symptoms. Half of the participants older than 23 years in nature-based services had not completed upper secondary school. The participants, including those with symptoms of mental health problems and low expectations at the outset of their participation, generally expressed high satisfaction with the services.

Much of contemporary health and mental health practice pays little attention to suffering, and when it does, invariably suffering is conflated with pain. Within such views, the health care practitioner ought to be concerned with removing or stopping the suffering as, for many parts of the occidental world at least, suffering is regarded as antagonistic to the pursuit of happiness. However, it has been recognized since ancient times that the experience of suffering can give rise to growth. This view sees suffering as an inevitable aspect of the human condition and experience; as something that might need to be endured, minimized, relieved, explored for meaning and maybe even learned from. The former conceptualization of suffering leaves little, if any, room for the sufferer to be to be proud of his suffering and to consider it ennobling rather than degrading, and such views are highly congruent with the increased pathologizing of 'everyday life' and with that, the inexorable proliferation of pharmacological treatment'. Accordingly, we assert that there is a clear need for Psychiatric/Mental Health nurses to re-think their views of suffering and consider how they might help the person discover meaning in the experience; how they might accompany the individual on his/her suffering journey. We therefore identify a range of approaches and interventions that Psychiatric/Mental Health nurses can use when attempting to help those experiencing mental health-related suffering. (C) 2014 Elsevier Inc. All rights reserved.

The aim of this article is to discuss methodological issues based on experiences involving the use of co-operative inquiry in a paediatric ward and to describe how the children’s own perspectives were taken into account. This project, which was conducted in Norway between 2004 and 2007, involved children, parents and health care professionals meeting in a mutual working process to apply a new pedagogic approach for children with asthma. Ninety individuals (children, parents, health care professionals, teachers and students) participated in the study that had a qualitative approach. The findings indicate that the adults considered the child perspectives throughout the project, while the children’s own perspectives were taken into account during the period of intervention. The children participated actively, which can support empowerment processes. Health care professionals and researchers responded to the children’s views using communication and research techniques adapted to the children’s age, development and sensitivity. Critical choices related to the project were made because of recruitment challenges involving children and families. Children between 7 and 10 years of age are competent actors who can be involved in research and thus represent activated sources of knowledge. Bringing about change requires endurance and a long-term perspective.