Integrated nursing care for people with combined mental health and substance use disorders.

Many health problems arise from mental, neurological, and substance use disorders. These disorders are highly prevalent and complex and contribute to poor health outcomes, premature mortality, security risk, social isolation, and global and national economic loss. Mental health and substance use disorders are among Australia's top four causes of disease burden. Our objective was to investigate and synthesize contemporary literature regarding factors that influence nurses' delivery of integrated care to people with combined mental health and substance use disorders within mental health services. We systematically searched five electronic databases with a limit on publications from 2009 to 2021. The search yielded 26 articles. Following thematic analysis, three themes were identified: individual nursing characteristics, nursing education, and professional development characteristics, and organizational factors. This study reveals that there is a fundamental absence of adequate integrative models of care within mental health services to enable the optimal nursing care of people with combined mental health and substance use disorders. Future research is needed to determine nurses' perceptions and factors influencing their role as participants in integrative care. The results could strengthen nurses' contributions in developing/adopting integrative models of care and contribute to clinical, educational, and organizational development.

Impact of strengths model training and supervision on the therapeutic practice of Australian mental health clinicians.

This study explored the impact of Strengths Model training, supervision and mentorship on the practice of a group of multi-disciplinary mental health clinicians that included mental health nurses, social workers, psychologists, and occupational therapists. A qualitative approach that combined critical realism and grounded theory was used. The findings demonstrated how a substantive category, Getting to Know Clients Better, facilitated participants' progression through a basic social psychological process, Becoming a Strengths-Informed Practitioner. This process consisted of a discernible and sustained change towards more person-centred, hopeful, and recovery-oriented practice. The findings also described an underlying generative mechanism for this, the Client Becomes Visible, which accorded with theoretical models of empathy, based on enhanced cognitive processing. The strength-based approach to practice facilitated the establishment of a collaborative relationship and a stronger therapeutic alliance between the client and clinician. The research demonstrated that Strengths Model is an effective vehicle for improving recovery-orientated mental health services.

Seeking and defining the 'special' in specialist mental health nursing: A theoretical construct.

In the context of an enduring debate about the distinct identity of mental health nursing, this qualitative study explored the nature, scope and consequences of mental health nursing practice. Data for interpretation were generated through interviews with 36 mental health nurses, five of their clients and one health care colleague, each of whom were asked to speak in as much detail as possible about what they believe is special about mental health nursing and what had influenced them to arrive at this understanding. Using a constructivist grounded theory approach, the study generated a substantive theory of recovery-focused mental health nursing expressed as 'Being in the here and now, side by side, co-constructing care'. The study revealed that the distinct nature and identity of mental health nursing provides the foundation that primes and drives practice scope and consequences. Conceptual interpretations of the data emphasized the mental health nursing perspective of care as an acquired lens founded in nursing as a profession and enhanced by the relational interplay between the nurse and the client that facilitates the nurse to adopt recovery-focused practices. This theoretical construct holds the potential to be the mediating connection between client and mental health nurse. By situating mental health nursing and its central role in practice as something co-constructed, findings from this study can be expanded beyond the Australian context, particularly in terms of mental health nursing's distinct professional identity and practice.

Mental health nursing: Daring to be different, special and leading recovery-focused care?

How mental health nursing is differentiated from other disciplines and professions, and what special contribution mental health nurses make to health services, is a question at the heart of contemporary practice. One of the significant challenges for mental health nurses is identifying, developing and advancing those aspects of their practice that they consider differentiate them in the multi-disciplinary mental health care team and to articulate clearly what a mental health nurse is and does. This paper draws on data from interviews with 36 mental health nurses in Australia who identified their practice as autonomous. Participants were asked the question, "What's special about mental health nursing?" Constructivist grounded theory techniques were applied to the research process. Findings were formulated and expressed as the 'Ten P's of the professional profile that is mental health nursing', which are 'present', 'personal', 'participant partnering', 'professional', 'phenomenological', 'pragmatic', 'power-sharing', 'psycho-therapeutic', 'proud' and 'profound'. The combined elements of the findings present a theoretical construct of mental health nursing practice as something distinctive and special. It provides a model and exemplar for contemporary practice in mental health nursing, embracing the role of mental health nurses in the health care workforce as being well placed as providers of productive and effective care.