Undergraduate mental health nursing education in Australia: More than Mental Health First Aid

Another paper… this time addressing the very important topic about pre-registration mental health nursing education in Australia.

Mental Health First Aid training is designed to equip people with the skills to help others who may be developing mental health problems or experiencing mental health crises. This training has consistently been shown to increase: (1) the recognition of mental health problems; (2) the extent to which course trainees’ beliefs about treatment align with those of mental health professionals; (3) their intentions to help others; and (4) their confidence in their abilities to assist others. This paper presents a discussion of the potential role of Mental Health First Aid training in undergraduate mental health nursing education. Three databases (CINAHL, Medline, and PsycINFO) were searched to identify literature on Mental Health First Aid. Although Mental Health First Aid training has strong benefits, this first responder level of education is insufficient for nurses, from whom people expect to receive professional care. It is recommended that: (1) Mental Health First Aid training be made a pre-requisite of pre-registration nurse education, (2) registered nurses make a larger contribution to addressing the mental health needs of Australians requiring care, and (3) current registered nurses take responsibility for ensuring that they can provided basic mental health care, including undertaking training to rectify gaps in their knowledge.

Click here for more details… Happell, Wilson, McNamara 2014 MH Nurse Curriculum

…and follow for latest publication: here… https://www.researchgate.net/publication/265127066_Undergraduate_mental_health_nursing_education_in_Australia_More_than_Mental_Health_First_Aid

Recovery quilts – collaborations of caring

I have a colleague and friend who is unwell at the moment. It is an awful feeling when someone you know is really very sick – and finding ways to help, and showing you care makes all the world of difference…to them and you!

This blog aims to highlight one way to draw together the social capital among small groups of friends, colleagues, family… whoever… for the purpose of collaborating in the development of a quilt gift to give to a person who is recovering. Bringing together a group of people to collaborate in building a quilt as a gift, is one way in which it is possible to develop a tangible expression of care, concern and hopefulness for recovery. Quilts convey both a physical and an emotional warm, a closeness and some comfort, and the expression of these elements in a gift of a quilt can carry with it some positive affect to enhance recovery. I have written a paper about how this has been done in the past  - you can read more about some research about recovery quilting here.

Wabi-Sabi – imperfect is beautiful!

A collaborative quilt doesn’t need a great deal of sewing skill or expertise, and creating a project that non-sewers can be included in is possible. The quilt doesn’t need to be stitch-perfect. In Japanese culture there is a concept of Wabi-Sabi – imperfectly beautiful! I think collaborative care expressed in a quilt is an ideal match to the wabi-sabi concept. A little bit of guidance and some inspiration – everyone can have a go and contribute something, without the expectation of being perfect. A relaxed and inclusive way for everyone to work together. I have contributed to a few collaborative quilts – and in my experience, the beauty really is in the varied interpretations and inspirations of each contributor. The meaningfulness that is sewn into each block is a great way to ensure variety. And, with this level of flexibility – it works!

What is needed:

  • Someone that can lead the sewing and guide beginners (someone needs to have little bit of knowhow… but, you can manage with just  a ‘little’!)
  • Fabric for the top – avid quilters will have a stash! (they can’t help themselves!) Ask them to contribute some… or use some reclaimed/ vintage fabrics from an op-shop. Or – buy a ‘jelly roll’ (cut strips of fabric) from a patchwork or fabric shop. What ever you do to collect your fabric – you will need to give it to your quilting collaborators in a ready made/cut blocks. A block will be easiest to work with if it is a square shape. The size doesn’t matter – but do make sure that all of the blocks are exactly the same size. Here is a free pattern if you need one! And some youtube guidance if that helps!
  • Middle – batting. Go to a quilt/ fabric shop and buy the quantity you need. You don’t have to have batting… you might prefer to use a cosy backing instead (eg fleece or chenille). The batting is best new – choose a wash and wear type. I prefer bamboo or cotton.
  • Backing – can be a reclaimed sheet, tablecloth, curtain or bed spread (op-shop again!) Or – you can buy some plain fabric for the back.
  • Distribute the blocks to the collaborators and encourage people to have a go! The more that contribute – the more beautiful the diversity!

What to do with your block:

Here is a list of my favourite ideas about what to put on your block…. it is only a sample of ideas shared (and borrowed) to stimulate your own creativity! Pinterest is a great source of inspiration and has lots of tutorials and patterns to get you started if you need some! Remember to leave 1 1/2cm border around the edge so the blocks can be sewn together.

Here are some links to some craft sites that might be sources of creative inspiration for some!

https://www.facebook.com/thecraftsessions?fref=nf

https://www.facebook.com/mazeandvale

http://www.pinterest.com/search/pins/?q=quilts

https://www.facebook.com/thethreadstudio?fref=nf

https://www.facebook.com/vogueknittingmag?fref=nf

https://www.facebook.com/Attic24?fref=nf

http://www.pinterest.com/search/pins/?q=quilting&rs=ac&len=3

http://www.pinterest.com/rhondawilsonmhn/

http://www.pinterest.com/chirp9/quilts/

http://www.pinterest.com/pgillan3/

https://www.facebook.com/carolineroseart?fref=nf

Building and giving a quilt together

Relationships are strengthened, emotions are shared and comfort is provided in undertaking this type of collaborative activity.  All are stronger together. Have fun making and giving quilts in collaboration with others – a burden shared is a burden halved! And above all…. wabi-sabi! Imperfect can be beautiful – so enjoy the journey what ever your skills might be! Collaborative caring…

Acknowledgements

I have a few quilting, embroidery and textile artist brains trust that I turn to for ideas, inspiration, tutorage and rescue when needed. Thank you for your encouragement, generosity and skills! When I grow up – I hope to be as expert and generous as you all are in your quilting, embroidery and textiles! xo

Judith Burns

Meredith Harmer

Julie Dol

Pauline Gillan

Environmental changes to places that we love and the impact on mental health

Solastalgia

Solastalgia can be thought of a type of ‘homesickness’ that is experienced by people who have experienced a major change, and possibly the destruction of, their environment or place. People can experience grief, loss and anxiety and depression directly related to the degradation of their home or or place. It is important to recognise how people are connected to their surrounding and particularly attuned to their home, community, environment and to nature generally.  When you space and place in the world is changed beyond your control – it is unsettling. Recognising the distress that is caused early and providing timely support is important because in doing so appropriate responses and health care interventions can be put in place for individuals, groups and whole communities.

Our mental health is linked to the environment and where we live

There are a range of commentators about this topic in recent times (some are listed at the end of this blog). Some are listed below, in particular, Professor Glenn Albrecht has been instrumental in identifying the key issues in NSW. His TED Talk video here is useful for those that want to know a little more about Solastalgia, but also about Solaphilia – the opposite of Solastalgia. Solaphilia is a concept that highlights the innate sense that people have to love or appreciate their place, or environment, that is, our place as people in the natural environment. Albrecht (in his video) says that to some extent our appreciation of nature or our love for our surrounding is vital and is a buffer for solastaglia. Basically if we look after our place and environment, it is good for our mental health! But when we start to compromise the environment, we also (perhaps unintentionally), make people more vulnerable to mental heath problems such as depression. Our mental health and our place in the environment are intrinsically linked.

People have a natural attraction and appreciation of nature . This capacity to reason and understand the environment has safety implications. For example, people are don’t usually enjoy environmental factors that are threatening or that represent danger. People don’t usually enjoy a climate that is too hot or too cold. If we avoid environmental or climatic hazards – we lie longer and happier lives! 

Biophillia – our relationship with nature

Kellert (a biologist) wrote an interesting book about people and places (see below for the reference) and about how we interact with nature. He says that people are drawn to form emotional bonds and attachment with the natural environment and this impacts on a sense of mental health and well-being, so much so, that people experience the desire to control the environment, or as Kellert (2012) describes it, to have dominion over the natural environment. People experience a sense of connection, meaning and purpose related to their experiences of the natural environment that provides a sense of spiritual connection to the world beyond one’s self.

Kellert (2012) suggests that the human affinity for the natural environment is so strong that it is symbolically represented in images, language and designs and that this too enhances a sense of well-being for people. These core biophillic values help us to understand mental health and well-being of rural people with emergent mental health problems from a unique perspective, and to better understand the complex context in which mental health decline occurs for them.

Rural adversity

The dynamics of rural communities are changeable and respond to impacts such as environmental changes (for example, drought, flood, salinity, and/or climate change), mining operations and workforce dynamics, downturns in commodity prices, financial pressures with the lowering of land values and loss of productivity, export demands, fly-in-fly-out (FIFO) workforce, population declines and the related fragmentation of social networks, farm amalgamations and corporatisations, as well as the limited availability of educational and employment opportunities for rural people (Some authors  have written more about this…. eg Speldewinde).

Environmental examples were Solastalgia can develop in rural communities:

Salinity and rising water tables

The insidious impacts of dryland salinity, that is, the rise of a salty ground water table, is increased as deep-rooted trees are cleared from agricultural areas to make way for productive agricultural landscapes that include shallow-rooted cropping. Farming practices and environmental management are also threatened by a long-term downturn in commodity prices and other environmental impacts such as drought. Thus, the economic impacts are also significant, and when combined with the creeping effects of salinity, are recognised as a vulnerability for mental health decline of residents because psychological distress is frequently associated with people’s sense of place, while their relationships and lived experiences influence their psychological quality of life. Some studies have shown links between depression and salinity increases.

Coal seam and open cut mining

In NSW, open cut and coal seam gas mining have grown in prominence and residents of communities where mining occurs have had to adapt to this change. Some communities have struggled to find a balance between environment, people and mining. Albrecht says that the competing battles are between Solastalgia and one end of the spectrum and Solaphilia at the other end, thus the conflict is between environmental impacts on people and their need to maintain a connection with place that is protective of mental health generally. Albrecht an his colleagues have conducted soem research that has explored how mining in the Hunter region has impacted people and their emotional health, and he has been able to explain some of the profound discomforts that impact people in that region – for example, the loss of landscape and the scarred horizons can be very debilitating to some people with some people avoiding travel in the region to help them minimise their distress and discomfort at the sight of an altered landscape, despite the geography being part of their cultural place. 

Floods

South West Queensland and Northern NSW experienced have experienced some significant flooding in recent years. Communities established in floodplains for the ease of access to water (historically) are particularly at risk of flood events. Moree, NSW is an example, where flood events can see the main street and many dwelling inundated with flood waters. Despite the risks, local people are connected to their place, and how it looks and feels. Moree Plains Shire Council have just conducted a Floodplain Management Program and have identified houses that will need to be lifted to avoid floor flooding in the future. Even changes such as the retro- raising of house heights will change the street scape of a country town to some extent. On the one hand there is assistance, support and planning underway to to help the community, on the other hand people will experience change in regard to their environment and place… the environmental and human emotional conflict is challenging to balance and reconcile.

Drought

There are many stories of drought and the changes to landscape. Drought and depression are well recognised in tandem. However the length of drought and the grief and loss that is associated with drought can be further complicated when ideas about solastalgia are considered.

Volcanos

In Indonesia a recent study has shown by Warsini, West, Mills and Usher, links between depression, anxiety and the loss of place and home to people who have had volcano eruptions destroy their homes and livelihoods. While the geography still exists – some people are profoundly sad and distressed at the loss of their homes and places. Their connections with the place has been disrupted and that can be described as an experience of solastalgia – homesick for the past place that is gone forever, yet still being in the same geographic location.

 Keeping strong and resilient

Remember that early recognition of any mental health or emotional decline is important. The earlier problems are recognised the sooner and more successfully mental health help can be implemented.

Environmentally, we know that from time to time the unpredictable will occur. Getting through these times is challenging, however, good mental health support is an important aspect in community level recovery.

Being connected to place, environment and nature is important -people need to do that to be mentally healthy and well. Advocating for looking after the environment is important for the mental health and well being of us all. The more we can do to maintain balance in nature – the better our emotional being in the future.

More information:

Albrecht, G., Sartore, G., Connor, L., Higginbotham, N., Freeman, S., Kelly, B., . . . Pollard, G. (2007). Solastalgia: The distress caused by environmental change. Australasian Psychiatry, 15, S95-S98.

https://www.researchgate.net/publication/257458715_Rural_and_Regional_Mental_Health?ev=prf_pub

https://www.researchgate.net/publication/264636089_The_Psychosocial_Impact_of_Natural_Disasters_among_Adult_Survivors_An_Integrative_Review

Kellert, S. (2012). Birthright. People and nature in the modern world., Yale University Press.

Speldewinde, P. C., A. Cook, P. Davies and P. Weinstein (2009). “A relationship between environmnetal degradation and mental health in rural Western Australia.” Health & Place 15: 880-887.

Stokols, D., R. P. Lejano and J. Hipp (2013). “Enhancing the resilience of human-environment systems: A social ecological perspective.” Ecology and Society 18(1): 7.

Walker, B., C. S. Holling, S. R. Carptenter and A. Kinzig (2004). “Resilience, adaptability and transformability in social-ecological systems.” Ecology and Society 9(2).

 

What Are the Research Needs for the Field of Disaster Nursing? An International Delphi Study

 Jamie Ranse, RN, FACN, FCENA, BN, GCertClinEd, GCertClinEpi, MCritCarNurs;

Alison Hutton, RN, MACN, DipApSci(Nsg), BN, PaedCert MN, PhD;

Basseer Jeeawody, RN, FACMHN, BA(Hons), Psych DipNsg, MEd, PhD;1

Rhonda Wilson, RN, BNSc, MNurs(Hons) PhD

 

ABSTRACT Background: Internationally there is an increasing amount of peer-reviewed literature

pertaining to disaster nursing. The literature includes personal anecdotes, reflections, and

accounts of single case studies. Furthermore, issues such as the willingness of nurses to

assist in disasters, the role of nurses in disasters, leadership, competencies, and educational

preparedness for nurses have been the focus of the literature.

Aim: The aim of this research was to determine the international research priorities for

disaster nursing.

Method: This research used a three-round Delphi technique. The first round used a

face-to-face workshop to generate research statements with nursing members of the

World Association for Disaster and Emergency Medicine (WADEM). The second and

third rounds included the ranking of statements on a 5-point Likert scale with nursing

members of WADEM and the World Society of Disaster Nursing (WSDN). Statements

that achieved a mean of four or greater were considered a priority and progressed.

Results: Participants were from multiple countries. Research statements were generated

in the areas of: education, training, and curriculum; psychosocial; strategy, relationship,

and networking; and clinical practice. Psychosocial aspects of disaster nursing ranked the

highest, with five statements appearing in the top ten research areas, followed by state-
ments relating to: education, training, and curriculum; clinical practice; and finally,

strategy, relationship, and networking.

Conclusions: Future disaster nursing research should focus on the area of psychosocial

aspects of disaster nursing, in particular, both the psychosocial needs of a disaster-affected

community and the psychosocial wellbeing of nurses who assist in disaster health activities.

 

Downlaod here: Ranse, Hutton, Jeeawody, Wilson 2014 Disaster nursing research

People ask me where they can get mental health help… here are some tips.

Finding mental help – not easy – here are some tips:

 People often ask me “where can I find some help for my son or daughter for a mental health problem?” Recently I was asked for some information about helping a rural young person with self harm problems… There is no easy answer… there is no ‘one size fits all’ option for rural people – but here are some links, phone numbers and tips that might be useful:

http://au.reachout.com/Wellbeing/School-Uni-and-Study

http://au.reachout.com/Tough-Times/Somethings-not-right/Self-harm

http://au.reachout.com/What-is-self-harm

 http://www.youthbeyondblue.com/understand-what’s-going-on/self-harm-and-self-injury

 http://www.headspace.org.au/is-it-just-me/find-information/self-harm

 http://www.blackdoginstitute.org.au/public/gettinghelp/helpfullinks.cfm

The common advice is to go to the GP, try this too. But, don’t be alarmed if the GP doesn’t know how to fix the problem… hopefully she or he will be able to point you in the right direction to seeking other appropriate help. Sometimes the GP doesn’t feel equipped to know what to do either but she or he should be able to help you to  look for other resources.

Look for private mental health clinicians (eg nurse, psychologist, social worker, etc)- they are more likely to be able to often some focussed mental health help. Ask them about their qualifications and experience before embarking on treatment, especially for a child or young person. Try and select a clinicians who can build a strong rapport with young people – the trust that will build will be important in helping the young person to recover.

Ask your local state-based public health service to supply you with a list of options for your region… and ask them how to make an appointment. You could go to the reception desk of any community health or community mental health service to obtain this type of information.

Frequently the access to State health mental health services for young people is by phoning an ‘intake’ helpline. In NSW this phone number is 1800 011 511 or see this website for NSW contacts . However if you have an emergency situation then the Accident and Emergency department of your nearest hospital is the best option, and if it is a life threatening situation, then phone 000 for emergency services (police, ambulance or fire).

Health Direct is a 24 hour a day service – you can talk to a Registered Nurse day or night who will be able to help as well. Speak to a Registered Nurse by phoning this number: 1800 022 222. They also have a good list of links to mental health resources on their website...

Suicide Call Back Service is another useful 24 hour service. Phone 1300 659 467 to speak with a counsellor – day or night.

if you are lucky – you might have a headspace service in your town – there are 67 operating throughout Australia.

Never be afraid to ask RUOK? If you need some help with prompts for conversations about mental health or about asking if someone has been thinking about dying lately… or if they are thinking about doing something to end their life, then click of the RUOK to find out how to start those types of conversations and to find ways to help if someone is struggling.

And- don’t give up…. keep asking and keep seeking help until you find the mental health help you need for your child/ young person. It may not be an easy road – but if you can find one helpful person, then you might just start the ball rolling in the right direction and help might gather momentum.

This is not an exhaustive list of all that might be available – but it is a starting point… I hope it helps some people find the resources they  are loojkng for…