Providing nursing leadership in a community residential mental health setting.

The worldwide burden of mental illness is increasing. Strong leadership is increasingly emerging as a core component of good mental health nursing. The aim of this article is to demonstrate the ways in which nurses can provide strong and consistent leadership in a values-based practice environment that embodies respect for individuals' dignity and self-determination within a community residential mental health service, which provides a structural foundation for effective action. This is accomplished through the presentation of two vignettes, which highlight how the seemingly impossible becomes possible when an economic paradigm such as agency theory is exchanged for a sociological and psychological paradigm found in leadership as stewardship at the point of service. It is through stronger nursing leadership in mental health that stigma and discrimination can be reduced and better access to treatments and services can be gained by those with mental illness. Nurse leadership in mental health services is not new, but it is still relatively uncommon to see residential services for "high needs" individuals being led by nurses. How nurses meet the challenges faced by mental health services are often at the heart of effective leadership skills and strategies.

H1N1 pandemic planning in a mental health residential facility.

It is only in the past few years that the mental health impact of disasters has gained attention in research and planning. This article provides a perspective of the experience of the H1N1 outbreak in New Zealand and the response by nurses in a community mental health residential facility. The key lessons learned were: planning and managing for infectious diseases should be part of disaster planning, know your clients and your community, share your knowledge, support the mental health of individuals throughout, and expect reactions as part of recovery. More research and publications are needed in this area for nurses to fully support consumers through pandemics in a more integrated manner.

Nature & prevalence of stalking among New Zealand mental health clinicians.

Stalking involves recurrent and persistent unwanted communication or contact that generates fear for safety in the victims. This pilot study evaluated the nature and prevalence of stalking among New Zealand nurses and physicians working in mental health services. An anonymous questionnaire asking respondents to describe their experiences with 12 stalking behaviors was distributed to 895 clinicians. Results indicated that regardless of discipline, women were more likely than men to have experienced one or more stalking behaviors, including receiving unwanted telephone calls, letters, and approaches; receiving personal threats: and being followed, spied on, or subject to surveillance. Women also reported higher levels of fearfulness as a consequence of stalking behaviors. Nearly half of the stalkers were clients; the remaining were former partners, colleagues, or acquaintances. In client-related cases, the majority of respondents told their colleagues and supervisors first, and the majority found them to be the most helpful resource. The results of this pilot study indicate a need for further research focused on the stalking of mental health clinicians in New Zealand and for development of workplace policies for adequate response to the stalking of mental health clinicians.

Reconnecting with policy: requirements for survival as a mental health nurse.

This article discusses the disconnection between mental health nurses and policy, and the importance of reconnecting such relationships not only to benefit the consumers with whom we work but also to influence health care policies and, ultimately, contribute to strategies to improve the health of our nation. In this article, I draw on my own experiences and apply these to a discussion of how we, as mental health nurses, can influence and strengthen our relationships with nursing policy.

Mental health nursing in New Zealand primary health care.

International literature and New Zealand health policy is giving increased emphasis to the role of the primary health care sector in responding to mental health issues. These issues include the need for health promotion, improved detection and treatment of mild to moderate mental illness, and provision of mental health care to some of those with severe mental illness who traditionally receive care in secondary services. These developments challenge specialist mental health nurses to develop new roles which extend their practice into primary health care. In some parts of New Zealand this process has been under way for some time in the form of shared care projects. However developments currently are ad hoc. There is room for considerable development of specialist mental health nursing roles, including roles for nurse practitioners in primary mental health care.