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Fresh look at Nursing in Mental Health, Addiction

A fresh look at Nursing in the Mental Health & Addictions sector in New Zealand

Thursday July 19, 2007

Te Ao Maramatanga (New Zealand College of Mental Health Nurses) Inc is the professional body for Mental Health Nurses in New Zealand and is holding its inaugural conference in Hamilton today and tomorrow at the Novotel Tainui.

The conference opened with a powhiri at 8.30am today and was to be followed by the opening speaker Dame Margaret Bazely.

The College was established in 2004. Mental Health Nurses had previously joined the Australian College to form the Australia and New Zealand College of Mental Health nurses. 10 years later NZ Mental Health Nurses separated from Australia to form the NZ College. This separation allowed the college to form in a way that is uniquely NZ, recognising the Treaty of Waitangi and what this means to NZ Mental Health Nurses.

This is the inaugural conference and the theme 'A fresh look at nursing in the Mental Health & Addictions sector in New Zealand' offers the opportunity for Mental Health Nurses to get together to celebrate their expertise, their diversity and to consider how Mental Health Nursing will adapt and respond to the future needs of people using Mental Health and Addiction Services.

Mental Health Nursing needs to be responsive to the needs of the people they work with ensuring that as a profession they have the capability and capacity to needs of people accessing service. The 1996 Mason Report led to a significant increase in funding and a significant increase in the size and range of clinical services to meet the mental health needs of the population.

The Clinical Training Agency funded MH new graduate and post grad programmes have been a significant factor in developing the capability of the workforce over the past 10 years. The capacity of the workforce is an issue nationally and internationally. The reasons are complex however one of the reasons is the growth in services over the last 10 years. This situation is not likely to resolve in the near future as there is increasing diversity in the practice areas for MH nurses. There are opportunities for MH nurses as the primary and community sectors expand, the reliance on the bricks and mortar of inpatient services decreases, new services are developed in the wider community and the move toward community inclusion continues. MH nursing needs to be taking a fresh look at clinical practice and the roles that MH undertake, how we extend the traditional practice of MH nursing into other settings.

One example of the changing and advancing of practice is the increasing numbers of MH nurses working within primary services. The questions that we need to consider include what are the MH Nursing skills and knowledge required to work within PHOs, how do we prepare nurses to work in this area, how do we ensure better outcomes for people with MH needs within these settings, what can nurses offer individuals and groups, and does promotion and prevention become more of a focus?

Another example relates to the clear evidence that people with serious mental illness experience a disproportionate burden of physical ill health and premature death, even when suicide has been factored out. Lifestyle issues such as smoking, poor diet and lack of physical exercise are compounded by the tendency of many commonly prescribed psychotropic medications, particularly the atypical antipsychotic drugs, to be associated with the development of metabolic abnormalities.

MH Nurses need to ensure they have the opportunity to either refresh or develop their skills around assessment and screening of physical health issues. We need to do this because it will lead to better health outcomes for the people we work with and also because we can. As Registered nurses we have the scope to provide nursing assessment and care to the whole person * medicine does, but other disciplines don't. This is our point of difference and we need to be ensuring we have the required skills and knowledge to meet the needs of the people we work with.

Key strategy documents from the Ministry of Health and the Mental Health Commission set the scene for the delivery of mental health services in the future. The vision for mental health is set out in the government's policy Te Tahuhu (The Second National Mental Health Plan). Te Hononga, sits within that vision describing the destination towards which the Commission will be directing its efforts when Te Tahuhu is fully implemented.

As part of taking a fresh look at MH Nursing one of the shifts in focus will be thinking about nursing across the MH sector as opposed to the funding divisions of provider, primary and NGO sector and also how MH nursing works with other workforces i.e. peer support workers to meet the needs of people accessing services rather than remaining fixed within traditional roles.


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