Mental health nurse practitioners in Australia: Improving access to quality mental health care

Abstract

Under The Nurses Amendment (Nurse Practitioners) Act 1998, New South Wales became the first state in Australia to legislate for nurse practitioners. Mental health was identified as a priority 'area of practice' for nurse practitioners. Issues surrounding the implementation of the nurse practitioner role in Australia and the potential for the role to address the current crisis in mental health nursing and the mental health sector will be discussed. The potential for partnerships with other health-care providers, in particular medical practitioners, will demonstrate how successful implementation of the role can fulfil consumer demand for primary prevention counselling, improve access to mental health services and early intervention, and provide mental health services that better reflect national priorities. This examination of the Australian context will be contrasted with a review of the overseas literature on mental health nurse practitioners.

La pratique infirmière avancée : un choix qui s’impose pour la qualité des soins et services en santé mentale

“…In addition, researches, funded by the Canadian Services Research Foundation (CHSRF, 2010), shows that the contribution of advanced nursing practice has never been stronger and there is a broad consensus to its value for the Canadian health care system (Dicenso.et Lukosius-Briant, 2010 (Delaney et Ferguson, 2011 ;Hanrahan, Delaney et Merwin, 2010 ;Huckshorn, 2007). Le manque de formation théorique et clinique, la faible reconnaissance et l'insuffisance de soutien organisationnel seraient au premier rang des causes expliquant les difficultés des infirmières dans l'exercice de leur rôle (Fisher, 2005 ;Happell, 2009). Par ailleurs, on relève plusieurs disparités dans les définitions de rôles, les programmes de formation et les titres d'emplois.…”

“…Cet essai de pratique avait pour but de décrire en profondeur tant le processus d'intervention que les retombées de l'implantation d'un rôle de consultation-liaison de l'infirmière praticienne en santé mentale. Une collecte de données réalisée auprès de 123 patients et d'intervenants du milieu, poursuivie sur une période de plus de 10 mois, fournit des données objectives et précises démontrant les avantages liés au déploiement de cette pratique, notamment sur le plan de l'accessibilité aux services, de la qualité des soins et des résultats obtenus (Fisher, 2005 ;ACT Health, 2002). Ces données, ainsi que celles produites par d'autres projets pilotes, ont constitué un levier important pour le développement du rôle de l'infirmière praticienne en santé mentale, si bien qu'en 2004-2005, des changements législatifs et l'octroi de plusieurs postes assuraient une implantation plus complète de leur rôle.…”

Nursing Revolution in Australian Primary Mental Health

“…They are trained to manage both medical and psychiatric illness, reducing illness risk, and promoting health and wellbeing (Burman et al, 2009) especially in the long-term, physically and mentally ill (Vousden, Drago & Hadley, 1990;Smith, Allwright & O'Dowd, 2007). They have made inroads, for example, in the management of comorbid diabetes and depression (Astle, 2007;Ciechanowski, 2006 ;Katon et al, 2006;2005). Nurses can assist with management of the metabolic syndrome that frequently accompanies long-term use of anti-psychotic medications.…”

“…To-date, three levels of psychiatric nursing have evolved: traditional basic mental health nursing; novel advanced nursing; and, advanced nursing with prescribing rights (Keltner & Folks, 1999;Talley & Brooke, 1992). The advanced forms are partnering with primary care physicians in private practice (Fisher, 2005;Hurley et al, 2014). Psychiatrists are beginning to link up with these nurse specialists, at the GP clinics.…”

The role of nurse administrators and managers in quality psychiatric care

“…Patient safety is predicated on trust, open communication, and effective interdisciplinary teamwork and achieved by developing common understandings and expectations based on science and standards (34). Furthermore, such teamwork requires health professionals to collaborate on problems such as territorial boundaries and conflicts, different authority styles, decision-making and accountability, and confronting issues of trust and information sharing (35).…”