Mental health nurses' voices to lead
Thursday 12 May 2022
In this special article celebrating International Nurses Day, we hear from ACMHN Board Directors Donna Hansen-Vella and Richard Lakeman about mental health nurse (MHN) leadership: what it looks like, why Australia needs it, and how to empower MHNs to lead more.
MHNs are an essential part of Australia’s mental health care system. They bring the core values of care, nurturance, partnership, recovery, and hope that form the foundation of mental health nursing and which are needed more than ever in mental health services and public discourse.
“Mental health nursing is a big part of the solution. MHNs are the right people, who can deliver the right dose of the right care or treatment in a timely way to those most neglected and in need, if only they were empowered to do so,” ACMHN Board Director Richard Lakeman says.
This year’s International Nurses Day theme ‘A voice to lead – invest in nursing and respect rights to secure global health’ brings into view this persistent lack of empowerment for MHNs. Australia needs MHNs to lead now to solve the country’s mental health service crisis, yet, real action that enables them to live up to their full leadership potential is still sorely lacking.
“Australia spends more on mental health now than it has at any time in history, yet our systems are not working, and simply spending more is not the solution. Too often MHNs are treated as merely instrumental to medicine,” Richard says.
The potential for MHNs to lead is huge, and despite the restrictions placed on them, they continue to contribute.
“MHNs frequently find creative ways to meet the needs of people they work alongside in a context of well documented funding and policy constraints. They continue to lead implementation of workforce initiatives, for example, creating programs to effectively support early-career nurses who are learning the art and science of mental health nursing,” Donna says.
“They are one of the only disciplines who are skilled to therapeutically be with a person experiencing high distress or acute mental ill-health within hospitals, at any time of day or night,” she adds.
According to Richard, mental health nursing needs to be recognised as the first allied health profession and treated accordingly to ensure Australians get the best care possible.
“Nursing needs to be treated as a profession akin to others which have autonomy over their sphere of practice, can (if they choose) receive a subsidy for the services they provide, and define their own roles,” Richard says.
Drawing on their years of experience in the sector, Donna and Richard say that genuine care and kindness as well as clear articulation of the MHNs’ multiplicity of roles, and facilitation make good MHN leadership stand out.
“Good leaders treat every encounter with service users as a potential therapeutic encounter, one that can make a life changing and life affirming difference,” Richard says.
“Nurse leaders also challenge the status quo when necessary. This is closely followed by advocating for better outcomes, generous coaching, support for personal and professional development including championing clinical supervision. Good leaders always focus on client-centred approaches, innovation, and continuous improvement,” Donna says.
To enable MHNs to shine in Australia, Donna and Richard recommend introducing an undergraduate mental health nursing degree program, recognition through registration and credentialing, getting involved, and the Federal Government giving Credentialed Mental Health Nurses (CMHNs) broader access to Medicare Benefits Schedule item numbers including ‘Better Access’.
“The Federal Government needs to respect and value the significant contributions of MHNs by immediately including CMHNs as funded service providers under MBS, Better Access, and National Disability Insurance schemes,” Donna says.
“Mental health nursing leaders need to be political and find a voice amongst the cacophony of interest and lobby groups who currently shape the discourse, frame the problems and dictate the solutions (which are often calls for more of the same). MHNs need to forge alliances, particularly with service users, families, and communities. Our overly bureaucratic care systems that privilege managerialism over leadership need urgent reform,” Richard adds.
Donna currently works as a Mental Health Deputy Program Director in a public health service within Victoria. She is responsible for large multidisciplinary teams providing inpatient, community and hospital-based perinatal mental health services as well as mental health rehabilitation programs, which includes mental health sub-acute bed-based services and community mental health programs for people with multiple needs, including the homeless. Each day provides opportunities to work closely with very dedicated, compassionate mental health nurses, psychiatrists, psychologists, social workers, occupational therapists, admin and other support staff who make a significant difference to the recovery of people experiencing mental ill-health and distress, their families and/or carers and other supporters.
Richard is currently an Associate Professor in Mental Health. He develops and teaches postgraduate courses in mental health and mental health nursing and, also undertakes and supervises researchers. His career has often included lengthy times where he has done these things whilst also working in ‘clinical practice’. His ‘clinical’ work has mostly been with people with complex needs, in emergency departments, with those who find themselves homeless, on assertive community treatment teams or undertaking psychotherapy in groups or with individuals.