In this series, ACMHN members talk about their passion for mental health nursing and how they have grown professionally. This time, Sarah Wakholi discusses how her personal life guided her to become a mental health nurse, her focus on supporting women during the pre- and post-natal period, and how her “unconditional positive regard” approach when working encourages greater engagement with consumers.

Working in mental health, I’ve really found my calling. During my undergraduate degree program, I trained as a comprehensive registered nurse. When I first enrolled in the nursing degree, I knew little about mental health nursing and my understanding of mental health as an important part of holistic wellbeing was limited. Looking back now I see how naive I was because, in reality, mental health issues were all around me as a young migrant mother.

I had also grown up with a brother who struggled with a mental illness. My family never openly talked about my brother’s illness. There was a sense of blame and silence about it. I remember times when my brother would be triggered by being called ‘crazy’ and beaten up by people in the community because of the stereotypes they had in their minds about him. Consequently, he became distraught and fearful for his life. I would listen to his angry rants and disorganised speech all night, but he never hurt anyone. He was mostly a peaceful and perfect big brother to me, who cared very much for everyone. I grew up confused about why my brother was treated differently by both family and community members.

 
I now understand that my brother’s stress reaction was highly sensitised because of the traumatic experiences of beatings, bullying, and alienation. My brother’s struggle with mental illness, plus my own journey as a migrant, inspired me to pursue a career in mental health nursing.

 
When I studied the mental health unit in second year of nursing degree I was exposed to different ways of seeing and understanding human experiences and the impact of adverse childhood experiences on overall health. Mental health nursing was beckoning me as I felt strongly that I could apply myself and make a difference in people’s lives. I learnt to let go of stigma I had embodied from childhood, that used silence to shame those suffering from mental illness. In hindsight, my brother needed help, understanding, and support with basic human rights for him to function as a valued member of the community. My family needed psychoeducation to help them understand my brother’s needs so they could better support him.

With this realisation I vowed to do better, with a strong desire to rescue those suffering from mental illness. I worked hard at it, and I realised very quickly it was not just about me rescuing people, rather, it was more about acknowledging my own knowledge deficit and allowing myself to develop awareness. I learned this required what Karl Rogers proposed as ‘unconditional positive regard’ approach for those I was privileged to work with, believing in their ability to be active participants. Once I got this I started to feel more connected when interacting with clients. I also sensed that people were at ease with me, allowing for a therapeutic engagement to occur.

I have continued to advance my expertise in mental health practice by undertaking post graduate studies in mental health nursing. I am most passionate about early intervention, targeting the perinatal and postnatal period. I believe this is an important phase of working with parents as they figure out ways of supporting children’s mental health and their own wellbeing. I continue to learn and grow as I interact with work colleagues and the clients I meet through therapeutic engagement.

 
Maternal mental health is crucial to the outcomes of a child’s overall health and development. Maternal mental illness during the perinatal period can lead to developmental difficulties. Lack of appropriate support during the perinatal period leads to isolation of parents, who may already be struggling with adjusting to parenthood, predisposing them to depression and anxiety. Perinatal depression and anxiety are risk factors for childhood cognitive and behavioural difficulties (Howard & Khalifeh, 2020).

 
During my professional practice I have seen the impact of stigmatising mental illness and how it makes it so difficult for people to seek help for fear of possible repercussions of being labelled ‘mentally ill’. On the other hand, those who choose to get help are faced with growing waiting lists. Yet, early intervention is the most appropriate, inexpensive, and effective way of supporting and promoting mental health of parents and their children, reducing the burden on the healthcare costs associated with treating severe mental illness.

 
I believe that all nurses are capable of playing an important role in early intervention, provided they have access to resources and opportunities for ongoing professional development. Through self-awareness, nurses have the ability to provide holistic health care. I believe early intervention is the best form of promoting mental health during the perinatal period.

Reference

Howard, M.L.; & Khalifeh, H. (2020). Perinatal mental health: a review of progress and challenges. World psychiatry,19(3); 313-327. https://doi.org/10.1002/wps.20769