Realities of Mental Health Nursing Practice in Rural Australia

Mental health nursing as a distinct speciality has been in decline in New South Wales (NSW), Australia, for two decades. Arguably, this decline has worsened both consumer outcomes and the workplace experiences of mental health nurses. This article reports on a study designed to ascertain the nature of contemporary mental health nursing practice in New South Wales. The study utilised focus group research methodology, with participants recounting the realities of their day-to-day professional practice and perceptions of their professional identity. The findings indicate a contracting, if not moribund, profession; a decrease in the value attached to mental health nursing; and a pattern of persistent underfunding by successive governments of mental health services. An analysis of present and historical trends reveals there is a pressing need for a restructure and re-formation of mental health nursing in rural areas. This article links the shortage of mental health nurses in NSW to the closure of the mental health nursing register, a shift to comprehensive/generalist nurse education models, a perceived lack of nurses’ professional standing, and natural attrition without suitably qualified replacements. Mental health nurses in this study perceived that they were not valued by other health professionals or by their own managers. Participants in this study reported mental health nursing in rural areas was an unattractive career choice. These findings are important to the understanding of recruitment and retention issues in rural mental health nursing in Australia.     

Recognising Narcissistic Abuse and the Implications for Mental Health Nursing Practice

Emotional and psychological abuse are components of what are now more commonly accepted as aspects of domestic violence in addition to physical assault. Narcissistic abuse formulations of domestic violence are lesser known concepts and not recognised in UK health care in general, nor commonly in UK mental health services and by default mental health nursing. The effects on the individual who has experienced narcissistic abuse can be fatal or extremely debilitating, long lasting and individual recovery can be a complex process. This article will argue that the language and formulation of narcissistic abuse should be at the forefront of the multidisciplinary teams’, and in particular mental health nurses’ knowledge in order that victims can be directly supported or signposted to support to enable timely interventions and in-depth understanding.     

Mental Health Nursing Practice and Indigenous Australians: A Multi-Sited Ethnography

Criticism of public mental services provided to Indigenous Australians have persisted over the last two decades, despite several national reports and policies that have attempted to promote positive service change. Mental health nurses represent the largest professional group practising within these services. This paper reports on a multi-sited ethnography of mental health nursing practice as it relates to this group of mental health service users. It explores the beliefs and ideas that nurses identified about specialist mental health nursing practice and Indigenous Australians. The study found a disunited approach to practice during the fieldwork. Practice was expressed as a series of individual constructions built upon the nurses’ beliefs about Indigenous Australians and their experiences in practice with these peoples. The criticism of mental health services from Indigenous communities was understandable to the mental health nurses, but how they could address this through their individual practices was not always clear to them. The actions by public mental health services to improve cultural safety through generic training related to the broad area of Indigenous health and health service needs, does not appear to evolve into informed specialist mental health nursing practice for Indigenous Australian service users.     

Barriers to Evidence-Based Practice Utilization in Psychiatric/Mental Health Nursing

Many psychiatric/mental health nursing (PMHN) practices have been affected by old traditions and haphazard trial and error instead of by established scientific evidence. The purpose of this article is to explore and analyze the barriers surrounding evidence-based practice (EBP) in PMHN. I identify some strategies to overcome these barriers in an attempt to incorporate EBP within the framework of PMHN services. Barriers explain the lack of EBP in today's PMHN environment. The barriers identified in this research are: the nature of the evidence, the contribution of the psychiatric nursing researchers to EBP, the personal characteristics of psychiatric nurses, and organizational factors. While the barriers to EBP for PMHN practice are clearly apparent, the challenge, now, is to build up creative strategies through which psychiatric nurses are better able to provide EBP care as part of their everyday performance. Adaptation of a more dynamic form of EBP, increasing the number of PMHN researchers, conducting clinical research projects, choosing suitable journals for publication, training the psychiatric nurses about computer skills, integrating the EBP principles into nursing curricula, developing journal clubs, and offering organizational facilitators are essential prerequisites for the achievement of EBP in the PMHN field. It is no longer justifiable for psychiatric nurses to be deficient in knowledge and skill since the advantages of EBP for patients are well-documented.