Following the closure of the large psychiatric institutions in New Zealand, there is an increasing demand for limited beds in acute inpatient facilities for acutely mentally ill patients. This change in location and downsizing of acute inpatient beds has challenged traditional roles of mental health nursing, resulting in confusion over what roles mental health nurses should now perform in the new context of care. This study compared the perceptions that registered psychiatric nurses have of their roles with their actual practice. This qualitative descriptive exploratory study observed nursing practice on three selected wards and used focus group interviews to establish from registered nurses what they perceived their roles to be. A key finding of this study was that many of the nursing roles related to delivering care from a crisis management perspective, which covers aspects such as assessment, stabilization of symptoms and discharge planning. Participants also believed that the therapeutic relationship was a fundamental role in inpatient care. Nurses used any opportunity to make it a reality such as kitchen organization, medications, or dealing with a challenging patient. This study highlighted the complexity of the roles that nurses performed and went some way to give voice to what at times seems an invisible practice.
Community-based participatory research (CBPR) is an approach that involves community members in research, not as research participants, but as partners. However, few studies have examined CBPR projects conducted among African Americans with serious and persistent mental illness (SPMI). This article focuses specifically on the Inspiring Change (IC) model, which includes a leadership trio comprised of an academic researcher, health service provider and an African American with lived experience of SPMI. Our purpose is to investigate how the IC model shapes not only how research is conducted but how research is understood and experienced by the community. We achieve this purpose by (1) describing an innovative CBPR model and pilot projects that involved African Americans with SPMI in all stages of the research project; and (2) presenting findings from qualitative interviews conducted with CBPR team members about strengths, challenges and leadership particular to this model of CBPR, an area rarely explored in CBPR literature. With the guidance of an advisory board and the manualised IC curriculum, two CBPR teams initiated and conducted nine-month long research projects focusing on health disparities for African Americans with SPMI. Members of the two CBPR teams (n = 13), which included individuals with lived experience, service providers and researchers, completed qualitative interviews. Benefits of CBPR projects included opportunities to learn, a sense of purpose in helping others and increased trust of research participants. Challenges pertained to disorganisation of leadership, lack of transparency with compensation, time pressures and interpersonal conflicts. These challenges highlight the importance of preparing and supporting those from both academic and lived experience backgrounds in skills necessary to thrive in leadership roles for CBPR projects.
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