Managerial support of community mental health nurses

AIMS: This paper is a report of a study to describe the support behaviours practised by managers of community mental health nurses (CMHNs) who provide homecare for people with mental illness, and to identify factors related to those behaviours. BACKGROUND: Homecare of mentally ill clients can prevent hospital readmission, provide rehabilitation, and include support for medication adherence, personal relationships, mental health, activities of daily living, as well as supporting informal caregivers. However, this work is stressful for CMHNs, who can themselves develop mental health problems and suffer burnout. Therefore support for these nurses is essential. METHOD: Semi-structured interviews were conducted with 10 nurse managers in 2004. A constant comparative data collection and analysis process was used, and a core category identified. FINDINGS: Four categories of managerial support behaviour were identified: (1) 'modifying client-nurse relationships'; (2) 'ensuring community mental health nurse safety'; (3) 'providing emotional support'; (4) 'providing opportunities for skill development'. 'To continue homecare for clients in need' emerged as a core category, representing the ultimate purpose of managerial support behaviours. Moreover, the timing of managerial support behaviours was influenced by the quality and length of the client-nurse relationship. CONCLUSION: The managerial support behaviours reported in the present study may be useful in other cultural contexts. Further research is needed to evaluate their effectiveness for CMHNs in other settings in Japan and other countries.