DEVELOPING NURSING RESOURCES
FOR MENTAL HEALTH

Why develop Nursing Resources for Mental Health?
 

Mental health is crucial to the well-being of individuals, societies and countries: Mental health is more than the absence of mental disorders. It involves a state of well-being whereby the individual recognises their abilities, is able to cope with the normal stresses of life, works productively and contributes to the community.

Mental health problems are common: 450 million people suffer from a mental or behavioural problem and nearly one million people commit suicide every year. Depression, alcohol use disorders, schizophrenia and bipolar disorder are among the ten leading causes of disability worldwide.

Treatment is not available to most people: Despite the existence of effective treatments, these are not available to the overwhelming majority of people with a mental disorder. Many of the resources that are available are wasted on ineffective interventions.

Nurses are important providers of treatment and care: In most countries, nurses are the largest group of professionals providing mental health care in both primary and specialist health services. However, in many countries the education of nurses is inadequate and their role is under developed. With education and support, nurses can contribute to the promotion of mental health and the prevention and treatment of mental disorders.

What are the priorities?

1. Primary Health Care

WHO recommends that mental health treatment should be part of or integrated into primary health care. However, many nurses lack the knowledge and skills to identify and treat mental disorders. Education is effective in improving the recognition of mental disorders in primary health care, increasing the referral to more specialised health providers and enhancing the initiation of supportive therapies. In addition ongoing supervision and support from specialist mental health services are needed to assist nurses to care for people with more complex mental health needs and facilitate referral to specialist services when required.

2. Nurse Education

Mental health should be incorporated into basic nursing and midwifery education with mental health concepts introduced early, reinforced and expanded throughout the curricula and developed through experiential learning opportunities. Ongoing education is also needed to assist nurses to further develop their knowledge and skills, foster changes in attitudes and beliefs and reorient them from custodial models of mental health care to community based treatment. Specialist or post-basic education programmes for nurses should be established to ensure that nurses are able to provide services for people with severe mental disorders and provide support to primary care providers.

The areas to include in the education of nurses will depend on the needs of the country, the role of the nurse, current competencies and the resources that are available. The following is not intended as a comprehensive list of areas for education, but as general guidance when developing education programmes:

• Advocacy
• Assessment of mental disorders
• Communication skills
• Community mental health nursing
• Emotional self care (i.e. Nurses caring for their own mental health)
• Evaluation and research
• Legal and ethical issues, including understanding the rights of people with mental disorders
• Management of emergencies (e.g. suicidal behaviour, violence)
• Management of psychotropic medication
• Mental health care in humanitarian emergencies
• Promotion of mental health
• Public health models of mental health
• Stigma and discrimination
• Substance abuse
• Treatment of mental disorders
• Working in teams
• Working with service users and their families
• Working with specific groups (e.g. children and adolescents, elderly)

It is important to ensure that educational programmes include practical opportunities to develop skills.

3. Involve nurses in the development of mental health policies

Mental health policies define a vision for improving mental health and reducing the burden of mental disorders in a population, and establish a model for action based on agreed values, principles and objectives.  Nurses are important stakeholders who should be consulted and actively involved in the development policies and plans. The development of nursing resources for mental health should be coordinated through a mental health policy. The WHO Fact Sheet 'Mental health policies and service development' provides more information on developing and implementing policies and plans.

4. Information for decision-making

While there is a growing body of research documenting good practice, many countries have little or no information on the size, composition, or quality of their nursing workforce for mental health, and no knowledge of their impact on health outcomes. It is important that countries gather this information in order to better inform mental health policy development and the role of nursing within this context.

FOR MORE INFORMATION, CONTACT

References

International Council of Nurses (2002), ICN Position Statement on Mental Health. http://www.icn.ch/.

World Health Organization (2001). Atlas:  Mental Health Resources in the World 2001. Geneva, World Health Organization.

World Health Organization (2001). The World Health Report 2001 – Mental Health: New Understanding, New Hope. Geneva, World Health Organization.

World Health Organization (2003), Factsheet ‘Mental health policies and service development’ http://www.who.int/mental_health/resources/publications/en/.

World Health Organization (2003), Investing in Mental Health WHO: Geneva.

World Health Organization (2003).  WHO Mental Health Policy and Service Guidance Package: Organization of Services for Mental Health. Geneva: World Health Organization.

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