Integrating mental health care for non-mental health nurses

According to the Australian Institute of Health and Welfare (AIHW 2019), over 4 per cent of Australians will experience a common mental disorder in their lifetime; the most common disorders experienced include anxiety disorder, affective disorder, and substance use disorders. In fact, mental disorders are cited in the top five disease group burdens in Australia (AIHW 2019).

Close to 2 million Australians will experience a co-occurrence of a mental disorder and physical condition each year, one in four requiring hospitalisation (Gentil et al., 2019). People experiencing co-occurring mental and physical disorders are more likely to experience more severe and chronic medical, social, and emotional problems than if they had a single disease or disorder (Australian Bureau of Statistics 2020-2022).

Judith Smith MACN, Director of Professional Development at the Australian College of Nursing (ACN), sat down with Scott Neirinckx, presenter of the Integrating Mental Health Care for Non-Mental Health Nurses Workshop, to discuss the importance of equipping nurses with knowledge and skills to manage people in their care with a mental health disorder.

Judy: Scott, can you tell us about yourself and your experience in mental health nursing?

Scott: I am a registered nurse with over 20 years of experience working across a variety of roles in both the public and private sectors. My expertise lies in mental health, and my passion for collaborative work and my ability to build partnerships have earned me recognition as a leader in my field. In my current role, I serve as the After-Hours Manager for Hornsby Ku-Ring-Gai Mental Health Service in the Northern Sydney Local Health District. Additionally, I am the owner and Director of Next Progression – Specialist Mental Health Services and recently was appointed a University of Technology (UTS) Ambassador.

In my career, I have held team leader and management positions in the community mental health sector for over 15 years. I also served as the Senior State-wide Clinical Advisor to the NSW Police Force for two years and worked as a Casual Academic at UTS, teaching undergraduate nursing mental health and professionalism subjects for over a decade.

My lifelong passion revolves around reducing the stigma associated with mental health struggles, and I strongly believe in the power of connectedness, collaboration, and supported decision-making. This belief prompted me to establish my own company, Next Progression, in 2021. As a specialist mental health service, we provide tailor-designed training, education, and consultation. Notable organisations, such as the NSW Police Force, ACN, and individual NDIS providers, have already benefited from our bespoke training packages.

Judy: Can you explain what mental illness is?

Scott: Well that depends really…. Are you asking for the clinical definition or the legal definition? AND it depends on which state you live in… better come to my course to find out more!

But for today, to really simplify things, in essence, mental illness involves a disruption in the ‘typical’ flow between event, thought, and action. When this flow is impacted to the point of disrupting a person’s function, then it could be classified as a mental illness.

Judy: What role do you think stigma plays in impacting safe and effective physical health care for patients with a mental health diagnosis or challenge?

Scott: Regrettably, I have observed stigma affecting the provision of safe and effective care on numerous occasions. One significant obstacle is the apprehension that clinicians may feel upon learning that they are caring for a patient with a diagnosed mental illness. I don’t criticise general nurses for experiencing this fear because it often stems from a lack of understanding and the unfortunate societal stigma associated with mental illness, especially severe and enduring conditions like schizophrenia or bipolar disorder. Stigma is shifting, and education is increasing, reflecting steps toward comprehensive/holistic care. Through understanding, knowledge, collaboration (among consumers, carers, disciplines, and specialties), and empathy, we can anticipate improved physical health outcomes for patients with mental health diagnoses, overcoming the historical overshadowing of their physical health by mental illness, which has led to poor outcomes for this population.

Judy: Why is it important for non-mental health nurses to be able to recognise mental health disorders in the people they care for?

Scott: It is crucial for non-mental health nurses to recognise mental health disorders in the people they care for because it allows for appropriate referral to specialised mental health services, understanding the impact of trauma, and the importance of trauma-informed care. Recognising mental health disorders also enables nurses to adapt their communication and care approach, acknowledging that individuals may not be able to follow simple instructions due to symptoms like auditory hallucinations, paranoid thoughts, or thought blocking, etc., associated with mental ill health. This recognition not only enhances overall patient care and contributes to better outcomes but also makes the nurse’s life easier by reducing frustration and facilitating a more effective and compassionate caregiving experience.

Judy: In your workshop ‘Integrating Mental Health Care for Non-Mental Health Nurses’, you discuss trauma-informed care (TIC). Can you explain what this is and why it is important for nurses to be aware of it?

Scott: Very simply, TIC focuses on safety, trust, and healing by acknowledging and addressing the effects of trauma on individuals, fostering collaboration, and showing sensitivity to individuals’ specific needs. A good example of an initiative to address TIC is the recently released NSW Health Integrated Trauma-Informed Care Framework, which focuses on a system-wide approach to TIC, not just within mental health services. This is a significant initiative, and other states and services will likely follow suit in recognising the importance of TIC.

Consider your preferred learning style when selecting CPD activities. If you thrive in interactive environments, workshops and seminars might be ideal. If you prefer self-paced learning, online courses or webinars could be a better fit. By choosing CPD activities strategically, you can ensure that your learning is both relevant and impactful.

Judy: How can non-mental health nurses better equip themselves to manage people in their care with mental health disorders?

Scott: Enrolling in this course is a key step, and joking aside, education and repetition are crucial. The fact is, over 45 per cent of people in Australia will, at some point, receive a mental illness diagnosis. The likelihood of encountering such individuals in your work is significant. Perhaps, in the future, we will see mental health education being given the same priority or mandate as training on deteriorating patient care in our workplaces…. Maybe!

Every nurse, no matter the setting, will encounter patients facing mental health challenges. To provide truly holistic, patient-centred care, it’s vital to understand the link between physical and mental health and be equipped to provide the right support. ACN’s Integrating Mental Health Care for Non-Mental Health Nurses course is designed to build on your existing expertise, giving you the skills and confidence to address mental health needs within your current specialty.

This article was originally published in the Autumn 2024 edition of ACN’s quarterly member publication The Hive. Members can access all past editions of The Hive on MyACN. Non-members can get a sneak peek by viewing our open-access articles.