Mental health nurses lead the way at Head to Health clinic in Parramatta
Australian College of Mental Health Nurses member Sarah Dickinson and fellow mental health nurse Efraim Rosso are spearheading one of Australia’s new Head to Health (H2H) clinics, showcasing the unique and invaluable contributions mental health nurses make to people’s physical and mental wellbeing.
People the world over have been feeling the mental strain of the COVID-19 pandemic causing a massive wave of demand for mental health care services, many of which are already under enormous pressure.
To safeguard against the impact of this wave, the Australian Government has been funding new H2H pop-up clinics – a place where people of all ages facing mental health issues can seek support free of charge.
At the H2H hub delivered by Uniting NSW/ACT in the Western Sydney suburb of Parramatta, two mental health nurses, Sarah Dickinson, the Service Manager and Efraim Rosso, the Senior Clinician, have taken the reins bringing a wealth of experience and a holistic approach to caring for clients.
“We noticed early on that we could use our skills best if we put a mental health nurse at the forefront of the H2H clinic. That is quite different to some of the other H2H hubs,” Sarah, who is also a Credentialed Mental Health Nurse, says.
“We decided that Efraim, with 30 years of experience as a mental health nurse should be the front of shop, doing the assessments.”
When a client books an appointment with the H2H clinic, Efraim is the first person to see them and get a picture of their situation.
“We then sit down with them and do a biopsychosocial assessment to find out what brought them in and how we can help. This is where your skills as a mental health nurse come in, to help you conceptualise the problem considering the physical, social and the psychological aspects of the presentation. We look at the person holistically, critically assess what we see and hear, and then form a base and a plan as well as an appropriate referral process,” Efraim says.
Telling the story of a client who has been facing long-standing issues with anxiety and depression, but also suffering complex medical conditions, Efraim highlights the unique skill set that mental health nurses bring to the table to help patients with similar backstories.
“It’s a narrative approach, it’s a journey with a consumer, not just about the psychological condition, but also the physical condition. We know that the psychological affects the physical and vice versa, and you gain insight pretty quickly if you have a strong base in mental health examination,” Efraim says.
“As mental health nurses we see people at their most vulnerable and we get to bear witness to and advocate for that as we walk alongside those consumers to bring about the change that this consumer wants.”
Some organisations have a very strong voice in the field of mental health, and Sarah says that it is easy to forget that there are many disciplines working in mental health with their own unique lens and skillset.
“At our H2H hub we’re a multidisciplinary team and we all bring something different to the table. For example, people can readily identify the role of the psychologist in the mental health arena, but we want to shine a light on the fact that there are other pathways for treatment of mental health conditions," Sarah says.
“It’s a shame that mental health nurses don’t have more opportunities. We’re supported within the H2H model, but considering the limited number of MBS items we can use, we can’t go out there independently and get paid. There is so much scope and opportunity for nurses to fill the skills void, particularly with our foundation in the medical model and with the current shortage of psychiatrists, financially it makes sense”.
“There’s a limited pool of money for mental health funding despite the growing mental health crisis, so doing the best job possible with that limited amount of resources is crucial. Mental health nurses’ skills in understanding diagnostic formulation and applying clinical judgement provides the right treatment and supports at the right time, particularly when we are seeing more and more complex client presentations. We’re certainly being overlooked in that regard.”
Every registered nurse has completed a three- or four-year degree in a health science, this includes mandatory client-facing hours of clinical experience and competencies.
To be recognised as a Credentialed Mental Health Nurse, evidence of specialisation by completing a postgraduate diploma or master of mental health nursing and several years of experience in the field, regular clinical supervision arrangements and further CPD need to be maintained as the Credential is reassessed every three years.
“It’s an intensive process, it is not awarded lightly,” Sarah says.
Both Efraim and Sarah would love to see more recognition of mental health nurses, their skills, and their contributions to Australia’s mental health care system.
“Working at H2H has reignited that sense that we’re not just a nurse, just a person who writes files and gives out medications, but we have an incredible skillset and a unique way of walking alongside clients and their families to formulate a plan and bring about better mental health outcomes,” Efraim says.
“We can’t affect too much change over what we can’t control. But what we can do is give ourselves the validation for what we do, look at our practice, evidence-based interventions, and our education and recognise that we’re robust clinicians and speak to the power that we have and advocate for ourselves. Our voice is important.”
“We need to push our identities as mental health nurses more. You don’t need to replicate what other professionals are doing, we’re different, and that’s a good thing. I’d like to see that more and I’d love to see membership of the College growing to see that this is a valid thing to be part of and that it is doing something for the profession,” Sarah adds.
Efraim is a clinician of approximately 30 years with a wealth of experience across mental health and medical nursing, in both the public and private sectors. Through his early years, he worked as a nurse counsellor specialising in military- and occupational-acquired trauma along with general psychiatry and drug and alcohol services. After a tree change, he invested in rural/remote nursing adding learning and experiences including A&E, acute and palliative care. Returning to the big smoke, he redirected toward mental health again holding management positions in mood disorders, drug and alcohol units as well as a director of nursing position before coming to the H2H clinic.
Sarah is a registered nurse with over 16 years experience working in mental health across multiple settings including acute, community, speciality teams and within the university sector. She holds postgraduate mental health nursing qualifications as well as qualifications in leadership and policy. Sarah has been an ACMHN member for many years and is also a Credentialed Mental Health Nurse. She is passionate about increasing recognition for the mental health nursing profession. Sarah is currently working in a service manager role for Uniting across mental health teams.
Sarah Dickinson, CMHN