Global focus, local acts: providing mental health services to indigenous people.

Four fundamental challenges to the provision of mental health services to indigenous populations are discussed, including proximity to services, community knowledge of mental health principles, human resource use, and cultural congruence. We describe concepts common to most indigenous approaches to mental well-being, including restoring health through balance and relatedness. Some strategies of practice are suggested to facilitate the cultural competence of psychiatric nurses and other mental health professionals who work with indigenous peoples. We contend that changes in availability of mental health services to indigenous peoples across the globe can be initiated with local actions by professionals who serve this population.

Creating a space for recovery-focused psychiatric nursing care.

Within contemporary mental health-care, power relationships are regularly played out between psychiatric nurses and service users. These power relationships are often imperceptible to the practicing nurse. For instance, in times of distress, service users often turn to or/and 'construct' discourses, beliefs and knowledge that are at odds with those which psychiatric nurses rely on to inform them of the mental status of the service user. The psychiatric nurse is in the position to impose knowledge onto service users, usually in concurrence with 'traditional or bio-psychiatry', without realizing or failing to acknowledge that the service user may have an alternative explanation of his/her mental health problems/experiences. In this paper, practice examples, based on the experiences of the four authors (from within and outside of services), are used to illustrate this 'hidden' power relationship. The authors use Foucault's ideas about: (i) government; (ii) the knowledge/power nexus and resistance; (iii) and his analytic tool of genealogy to help unravel this paradox within psychiatric nursing practice. The authors also use the emerging discourse of recovery as an alternative (and challenge) to 'traditional bio-psychiatry' and consider the implications for psychiatric nursing practice.