Australian and New Zealand Journal of Mental Health Nursing (Aust New Zeal J Ment Health Nurs)

Publications in this journal

• Article: Alexithymia: a challenge for mental health nursing practice.

  A Tacon
  [show abstract] [hide abstract]
  ABSTRACT: Alexithymia, under-recognized and under-diagnosed, presents a significant challenge to mental health nurses. This article explores the alexithymia construct, and presents the view that better recognition of this trait will allow nursing intervention to be more specific and effective. The mental health nurses' role is potentially the cornerstone of successful intervention with this group of complex patients, who do poorly when offered conventional, insight-orientated interventions. Standard psychotherapeutic treatments need to be modified in order to focus on increasing the ability to self-regulate affect, otherwise treatment may be both counterproductive and potentially damaging.
  Australian and New Zealand Journal of Mental Health Nursing 01/2002; 10(4):229-35.
• Article: The Tasmanian children's project: the needs of children with a parent/carer with a mental illness.

  C Handley, G A Farrell, A Josephs, A Hanke, M Hazelton
  [show abstract] [hide abstract]
  ABSTRACT: This paper presents some of the key findings and recommendations of the report The Tasmanian Children's Project (TCP): The Needs of Children with a Parent/Carer with a Mental Illness, October, 1999. The TCP, a collaborative venture between the University of Tasmania's School of Nursing and the Mental Health Services - South, Tasmania (Department of Health and Human Services), is the first study in Tasmania to formally examine the needs of children where the parent/carer has a mental illness. The study is a modified replication and extension of the 1993/94 Victorian Children's Project. Extension aspects of the TCP included interviews with children (in addition to parents and service providers), the inclusion of data on both maternal and paternal mental illness and a broad definition of mental illness (beyond psychotic illness and major affective disorder). The report highlights the need to provide a range of programs that encourage the development of personal competency among children, parents, and other family members and those that emphasize interagency collaboration. Implications of this research for mental health nursing education and practice are also addressed.
  Australian and New Zealand Journal of Mental Health Nursing 01/2002; 10(4):221-8.
• Article: The impact of relocation on elderly patients with mental illness.

  T Meehan, S Robertson, C Vermeer
  [show abstract] [hide abstract]
  ABSTRACT: Twenty-three elderly patients with long-term mental illness were relocated from a large tertiary mental health facility to two extended care units (ECUs) in their district of origin. The patients were assessed on measures of functioning, aggression and agitation at 6 weeks pre-relocation, and again at 6 weeks and 6 months post-relocation. The impact of relocation on the group proved to be less dramatic than findings reported in the literature. The adverse affects of relocation were likely to have been offset by the preparation and planning undertaken prior to relocation, and the support provided to staff and patients in the period following relocation. The findings have implications for nursing staff involved in the relocation of people with mental illness between wards within a hospital or from one hospital to another.
  Australian and New Zealand Journal of Mental Health Nursing 01/2002; 10(4):236-42.
• Article: Common experiences of mental health nurses and consumers: ingredients of a symbiotic relationship?

  E Shanley
  [show abstract] [hide abstract]
  ABSTRACT: Examination of the history of consumers and mental health nurses reveals that both consumers and mental health nurses have much in common in terms of their powerlessness and their sense of being undervalued. This paper argues that their common problems have a shared solution. It is in the interest of both groups to develop a symbiotic relationship, with each other benefiting by achieving greater influence over the delivery of care. The development of a close alliance requires a change in perception and behaviour towards each other. This paper identifies some of the factors militating against developing a symbiotic relationship and suggests possible ways of addressing them.
  Australian and New Zealand Journal of Mental Health Nursing 01/2002; 10(4):243-51.
• Article: The relationship between community psychiatric nurses and clients with severe and persistent mental illness: the client's experience.

  L O'Brien
  [show abstract] [hide abstract]
  ABSTRACT: The aim of this phenomenological study was to construct an interpretation of the experience of nurse-patient relationships, in the context of community psychiatric nursing. The purpose of this paper is to focus on the experience of the relationship from the perspective of the clients. Themes of 'having someone looking out for me', 'working in collaboration', and 'being understood and gaining understanding' were identified. This thematic structure was used to understand the meaning of the relationship for the clients. Implications for practice, education, clinical supervision and mental health services are discussed.
  Australian and New Zealand Journal of Mental Health Nursing 10/2001; 10(3):176-86.
• Article: Unearthing the conflicts between carer and custodian: implications of participation in Section 16 hearings under the Mental Health (Compulsory Assessment and Treatment) Act (1992).

  M Fishwick, B Tait, A J O'Brien
  [show abstract] [hide abstract]
  ABSTRACT: Mental health nursing occurs within a legal and ethical framework that presents conflicts between a paternalistic custodial role and an ethical commitment to autonomy. This paper considers the ethical conflict for nurses posed by acting as second health professional at judicial reviews under Section 16 of the Mental Health (Compulsory Treatment and Assessment) Act. Issues of advocacy and paternalism are discussed in light of the conflict between therapeutic and legislated roles. Strategies aimed at protecting the therapeutic relationship are outlined as a response to the current lack of guidelines in this area. Participation in legal processes of committal requires that nurses reflect carefully and critically on the ethical issues raised.
  Australian and New Zealand Journal of Mental Health Nursing 10/2001; 10(3):187-94.
• Article: A time for change?

  M Hazelton
  Australian and New Zealand Journal of Mental Health Nursing 10/2001; 10(3):135.
• Article: Taking neuroleptic medications as the treatment for schizophrenia: A phenomenological study.

  K Usher
  [show abstract] [hide abstract]
  ABSTRACT: Research in the area of neuroleptic medications has traditionally relied on quantitative methodologies which view the problem from the researcher's perspective. This phenomenological study was undertaken to explore the experience of taking neuroleptic medications from the individual's perspective using a research approach which has the potential to illuminate and respect participant experiences. Interviews were conducted with 10 individuals who take neuroleptic medications as their main treatment for schizophrenia. Interviews were analysed using an interpretive method which seeks to generate a deeper understanding of the phenomenon under study. The experience of taking neuroleptic medications emerged as incorporating hope for recovery, learning to live with the side-effects, embodiment of illness, experiencing issues of control, and struggling to stay well. The results have relevance for practicing and novice mental health nurses, for teachers of undergraduate nursing and allied health students, and carer and consumer groups.
  Australian and New Zealand Journal of Mental Health Nursing 10/2001; 10(3):145-55.
• Article: A philosophical analysis of evidence-based practice in mental health nursing.

  K Lines
  [show abstract] [hide abstract]
  ABSTRACT: Mental health nurses need to be aware that their knowledge base does not exist in isolation from other cultural practices. They/I/we must become more willing to engage in theoretical problem solving that directly affects clinical practice issues such as the introduction of evidence-based practice. Critical discussion of evidence-based practice should be informed by the complex issues that permeate all our socio-cultural and linguistic practices. This paper examines some of the major philosophical problems in the debate over the use of evidence-based practice in mental health nursing using both Foucault's formulation of discourse analysis and Derrida's construal of deconstruction. The conclusion reached is that postmodern philosophy offers a way to rid nursing of incessant naiive attacks on either quantitative or qualitative research methods which underpin the debate over evidence-based practice in mental health nursing.
  Australian and New Zealand Journal of Mental Health Nursing 10/2001; 10(3):167-75.
• Article: Coping with everyday reality: mental health professionals' reflections on the care provided in an acute psychiatric ward.

  J K Hummelvoll, E Severinsson
  [show abstract] [hide abstract]
  ABSTRACT: There is little research evidence about how the mental health professionals are coping with the complexity of everyday practice in psychiatric acute care. The aim of this study was to explore mental health professionals' reflections on their work on an acute psychiatric ward. Data were collected using participant observation and interview methods. Three core themes were identified from a qualitative hermeneutic analysis. The first core theme, coping with uncertainty, uncovered a dialectical pattern of the factors contributing to thriving and strain in the working situation. The second core theme, caring for the patient, included the caring process, patients' pathway to acute psychiatric care, as well as the patients' needs and roles on the ward. The third core theme, coping strategies, included five different methods the primary nursing system, concealing versus integrating, milieu therapy, seclusion and the medical orientated model. It was concluded that good mental health care is a result of collaboration between health professionals and the health services. This study highlights the need for support to professionals and for establishing structures that will enable collaboration to take place. Taken together, this may contribute to enhancing the care of the patient and their families.
  Australian and New Zealand Journal of Mental Health Nursing 10/2001; 10(3):156-66.
• Article: On the brink of change? Implications of the review of undergraduate education in New Zealand for mental health nursing.

  K Prebble
  [show abstract] [hide abstract]
  ABSTRACT: A New Zealand Nursing Council review of undergraduate education provides an ideal opportunity to make much needed changes to the system of preparation for mental health nurses. This article critiques comprehensive nursing education through an examination of its history in New Zealand, recent mental health reports and a projected estimate of workforce needs. Historical analysis reveals a process of marginalization and invisibilization of psychiatric/mental health nursing within comprehensive programmes with a consequent reduction of skills and a weakening of the profession. The author concludes that psychiatric/mental health nursing is a distinct scope of practice which requires specialty undergraduate preparation.
  Australian and New Zealand Journal of Mental Health Nursing 10/2001; 10(3):136-44.
• Article: Re-awakenings? A discourse analysis of the recovery from schizophrenia after medication change.

  T Rudge, K Morse
  [show abstract] [hide abstract]
  ABSTRACT: This paper explores the construction of recovery from schizophrenia after medication change through the analysis of people living with schizophrenia. The study is framed by a discourse analysis which assumes that the language used to discuss schizophrenia and its treatment by medication is imbued with the power relations of mental health. The analysis uses research literature, pharmaceutical literature and previous studies of schizophrenia as the discursive background that frames how recovery can be talked about. The discussion highlights how the discourses of medical science construct recovery as a linear event that silences the embodiment of schizophrenia. People with schizophrenia refuse this construction, through finding a 'niche' for themselves. In conclusion, the paper suggests how such analysis opens up for exploration of the silencing of 'insanity', and establishes a beginning dialogue with people who live with the continuing presence of schizophrenia.
  Australian and New Zealand Journal of Mental Health Nursing 07/2001; 10(2):66-76.
• Article: Survey of stakeholders' opinions of community psychiatric nursing services.

  E Shanley, G Watson, A Cole
  [show abstract] [hide abstract]
  ABSTRACT: The paper describes a telephone survey of the views of representatives of users, purchasers and providers of community psychiatric nursing services on services in Scotland. The telephone interview protocol was based on seven themes derived from interviewing 63 users, purchasers and providers throughout the UK. Descriptive statistics were used to present the responses in the survey to the forced choice questions. Responses to the open ended questions were coded, categorized and computed. The paper describes the responses by the major stakeholders to each of the themes. Overall, the quality of the existing services was placed in the 'good' category. However, criticism was directed at the insufficient numbers of Community Psychiatric Nurses in the service, the inadequate amount of time spent with clients and their poorly organized method of working. Other findings and stakeholders' recommendations are discussed.
  Australian and New Zealand Journal of Mental Health Nursing 07/2001; 10(2):77-86.
• Article: A consumer's perspective of a suicide intervention programme.

  S Aoun, L Johnson
  [show abstract] [hide abstract]
  ABSTRACT: The objective of this study was to assess the impact of a suicide intervention program from a consumer perspective. Self-administered questionnaires were distributed to consumers who had been referred to a suicide intervention counsellor in the 2-year period of the programme in rural southwest Western Australia. Three-quarters of respondents were positive about their experience with the service, with half of the respondents no longer having thoughts of suicide and only 20% of all respondents reporting having attempted deliberate self-harm postcounselling. Reported suicidal ideation and attempted self-harm were much higher in the dissatisfied group. Dissatisfaction of respondents stemmed from the history of their treatment and 'the hassle created by the many systems for them to access care'. However, the overall outcome of this study is that, from the consumer's perspective, a high intensity approach to suicide intervention resolved or improved the presenting problem and their ability to deal with it.
  Australian and New Zealand Journal of Mental Health Nursing 07/2001; 10(2):97-104.
• Article: On postdoctoral research fellowships in mental health nursing.

  N G Procter
  Australian and New Zealand Journal of Mental Health Nursing 07/2001; 10(2):65.
• Article: Negative attitudes towards clients with drug and alcohol related problems: finding the elusive solution.

  B Happell, C Taylor
  [show abstract] [hide abstract]
  ABSTRACT: The difficulties experienced by nurses in providing care to clients with drug and alcohol related problems within general hospital settings have been clearly identified in the literature. Despite this, the problem continues with little or no evidence of improvement. This paper reports the results of a research project undertaken in a large private hospital in metropolitan Melbourne, Victoria, Australia. The study sought to ascertain whether a difference in attitudes, confidence and perceived knowledge related to the care of clients with drug and alcohol problems would be evident between those nurses who used consultation and liaison services from a specialist drug and alcohol unit and those who did not. A questionnaire was administered to 200 nurses, with a 53% completion rate (n = 106). The results showed very little difference between the groups with the exception of the perceived knowledge category which indicated a statistically significant difference.
  Australian and New Zealand Journal of Mental Health Nursing 07/2001; 10(2):87-96.
• Article: Undergraduate nursing students' views of mental health nursing in the forensic environment.

  T Martin, B Happell
  [show abstract] [hide abstract]
  ABSTRACT: The literature clearly demonstrates that mental health nursing tends to be viewed negatively by undergraduate nursing students. While positive clinical experiences have been found to encourage more favourable attitudes towards mental health nursing, suitable placements are becoming scarce. An evaluation of clinical placements at the Victorian Institute of Forensic Mental Health (VIFMH) was undertaken to determine whether appropriate learning opportunities were offered, and identify the impact of the placement on students' attitudes to mental health nursing. The results suggest that VIFMH provides valuable learning experiences to increase students' understanding of mental health nursing and is effective in producing more positive attitudes towards this area of practice.
  Australian and New Zealand Journal of Mental Health Nursing 07/2001; 10(2):116-25.
• Article: Professional convergence in forensic practice.

  D Mercer, T Mason, J Richman
  [show abstract] [hide abstract]
  ABSTRACT: This paper outlines the development and convergence of forensic science and secure psychiatric services in the UK, locating the professionalization of forensic nursing within a complex web of political, economic, and ideological structures. It is suggested that a stagnation of the therapeutic enterprise in high and medium security provision has witnessed an intrusion of medical power into the societal body. Expanding technologies of control and surveillance are discussed in relation to the move from modernity to postmodernity and the ongoing dynamic of medicalized offending. Four aspects of globalization are identified as impacting upon the organization and application of forensic practice: (i) organized capitalism and the exhaustion of the welfare state; (ii) security versus danger and trust versus risk; (iii) science as a meta-language; and (iv) foreclosure as a mechanism of censorship. Finally, as a challenge for the profession, some predictions are offered about the future directions or demise of forensic nursing.
  Australian and New Zealand Journal of Mental Health Nursing 07/2001; 10(2):105-15.