Nurses ‘vital’ for tackling rising global mental health care needs
More funding, recognition and specialising is needed for mental health nursing to tackle global health inequalities, according to latest international guidelines.
The International Council of Nurses (ICN), a federation of more than 130 national nursing associations, has published its new Guidelines on Mental Health Nursing.
“In the face of rapidly evolving health care paradigms, the roles of mental health nurses have never been more vital”
Pamela Cipriano
The guidelines make the case for better investment and recognition of mental health nursing as an individual specialty, and encourage governments across the world to work towards an end to enormous regional variances in care.
ICN president Dr Pamela Cipriano said in a foreword to the document that she hoped it would demonstrate how nurses were “vital” to tackling an increasing need for mental health care across the globe.
“In the face of rapidly evolving health care paradigms, the roles of mental health nurses have never been more vital,” Dr Cipriano said.
She added: “Mental health is not just the absence of mental disorders; it is a state of overall wellbeing where individuals realize their own abilities, manage stress, work productively and contribute to communities.
“Mental health nurses are at the forefront of this mission and their expertise and skills are essential for creating responsive and person-centred health care systems in which to deliver compassionate care to.”
Dr Cipriano said her organisation was concerned with the “stigmatisation” of mental disorders, which continued in some countries.
She argued that a dedicated mental health nursing workforce in every country could help tackle this problem.
She said: “Mental health nurses are in unique positions to counteract these prejudices, not only by providing empathic, person-centred, evidence-based care, but also through public education and advocacy.”
The guidelines, published at the end of last month, set out five broad aims for all countries to adhere to when organising their mental health nursing workforce.
The first is to “integrate” mental health education into undergraduate nursing curricula, so all nurses – not just specialists – have fundamental knowledge of this area of health.
“This foundational competence is crucial for early identification, effective referral and management of mental health issues and for the provision of holistic and compassionate care,” the guidelines stated.
The ICN then went on to state the importance of having a mental health nursing specialty, on top of a general nurse population with an understanding of the field.
This, the guidelines said, included ensuring both that there were postgraduate-level mental health specialty nurses and advanced practice mental health nurses.
The ICN said these advanced nurses should have a minimum of a master’s degree, and be used to manage patients with mental health co-morbidities, implement “nuanced” interventions for these patients and act as leaders with more autonomy than the average mental health nurse.
Thirdly, the ICN called for an overall investment in mental health, and in particular mental health nursing, from governments and providers around the world.
This investment must include a commitment to “building a robust mental health nursing workforce”, including funding the implementation of advanced practice mental health nurses, said the ICN.
It also said investment was needed to address current gaps in nursing workforces, including in education and ongoing professional development structures to ensure nurses are “highly skilled and competent”.
The fourth standard outlined by the ICN advocated for mental health nurses to “champion” human rights in mental health settings by tackling the stigma, which Dr Cipriano warned patients faced.
“The ICN advocates for the essential inclusion of sessions on the needs and rights of those with mental health conditions in undergraduate nursing education, requiring co-delivery by people with lived experiences of mental health conditions,” it said.
“The ICN also calls for education programmes to have evidence-based stigma reduction competencies embedded in them to enable future nurses to address and counter stigma and discrimination faced by patients and clients effectively.”
Lastly, the council said that it was “imperative” governments around the world ensured the mental health nursing specialty – as a separate specialty to the rest of nursing – was formally recognised.
This should include “rigorous accreditation”, setting standards for mental health nurses and “elevating” the position of the specialty in a society.
After the publication of its guidelines, the ICN attended a World Health Organisation workshop on the implementation of pre-registration mental health and substance use education for health professionals.
At the event, Espen Gade Rolland, the Norwegian Nurses Organisation lead and contributor to the ICN guidelines, reiterated calls to impress on governments the importance of mental health nursing.
“Nurses are in the frontline of healthcare, providing a continuum of care that encompasses compassion, empathy, and unwavering dedication towards more humane, effective and inclusive health care services,” said Mr Rolland, while promoting the new guidelines.
