News

Mental Health – the need to balance the crisis- Nursing perspective

There has been a recent media coverage regarding serious and tragic events in the area of mental health and addiction services in New Zealand., As the national body representing the professional interests of mental health nurses, the New Zealand College of Mental Health Nurses Inc (Te Ao Māramatanga) believes it is important to offer a considered opinion regarding the challenges facing mental health nurses in in these areas.

We would like to call to the public attention to a wider consideration of the mental health and addictions context, including the influence that current policies have on clinical services. Nurses who work in mental health and addictions, do so within a stringent code of ethics, and a framework of professional standards. Mental health and addictions nurses have a strong work ethic, and a desire to support people to return as quickly as possible to wellness (recovery – alternative word), their home and community environment. There is often little recognition of the level of professional commitment needed, the significant knowledge and skills required and the enormous workload that goes on to achieve this. High quality care comes from an inter-professional team approach;80% of the registered healthcare workforce in mental health and addiction are nurses. Nursing in mental health and addictions is a wide ranging and expanding area. Current national mental health and addiction policy is clear about the need to keep the ‘patient’ , ‘service user’, ‘consumer’ at the centre of care, doing this in a way that includes family/ whānau and delivering care in the least restrictive and most collaborative way possible. As a College we are privy to the many areas, services, and places that care is provided in accordance with the national and local policies, and with little to no fanfare. The sensitive and personal nature of mental health and addiction problems means that for the most part, care provided is unsung and occurs very discreetly. People are treated according to their individual wishes and with respect for their culture. The vast majority of mental health and addiction care is provided in community settings, where people remain with their whanau and family, with support from clinical and support services. For reasons of privacy, most of this care is not publicly discussed. Coverage of adverse events therefore receives greater media prominence than coverage of the day to day care provided by mental health and addiction services. Recent media events are building a picture that mental health and addiction care occurs only in inpatient treatment services, and does not reflect the current practice environment. The current environment includes significant fiscal constraints, a strong drive to adhere to best practice in areas of reducing restrictive practices, and a commitment to providing person centred care. Acute services, both in the community and in hospital, are providing care for, a growing number of people with high complexity and multiple care needs, Inpatient services are often provided in buildings that are not purpose built or designed to support current policy imperatives. The College has long supported the policy direction of providing services close to home, to the least restrictive standard, and in collaboration with service users and their families. We continue to support that policy and would like to see more balanced media coverage that reflects the range of services provided and the care and support provided by mental health and addiction nurses throughout New Zealand.