Undergraduate mental health nursing education: Time to shut up?

Abstract

Undergraduate mental health nursing education has dominated the landscape, not only in Australia, but internationally, for decades now. It might prompt thoughts that perhaps we should move on. I disagree. The June editorial by Dianne Wynaden (2011) has got me thinking even more, hence this editorial is about education. Plainly, education needs to stay on the agenda until we as a profession feel that significant strides have been made. One of my biggest frustrations with undergraduate mental health nursing education in Australia is that so much activity has led to so little change, or at least changes likely to be sustainable in the long term. Yes, there have been wonderful innovations over the years, driven by passionate and resilient mental health nurses. Unfortunately, these initiatives have quickly fallen, as influential mental health nurse academics come and go from Schools of Nursing. At times, there are reasons to be optimistic. The recent Mental Health Nurse Education Taskforce (MHNET) report included strong recommendations to enhance and protect the integrity of mental health nursing in undergraduate programmes, and it was particularly pleasing that this report was endorsed by the Council of Deans of Nursing and Midwifery. The report provides some much welcomed clout, which I and several colleagues have used to fend off treats to mental health nursing from the predominantly medical–surgical-dominated curricula, but the extent to which this clout will be sustained in the long term remains tenuous at best. Only recently, two conversations with senior mental health nursing academics brought a crushing reminder that the battle is far from over. One colleague described a dilution in mental health content, which has essentially nullified the work initiated through the recent Commonwealth funding. So less than 3 years following implementation, they are all but gone. The other colleague had an opportunity to view the draft of a new curriculum, only to find that the mental health content had been totally integrated into other subjects, losing its presence not only as a specialist discipline, but as a core skill for nursing practice in all settings. This flies in the face of the MHNET recommendation that mental health content be both compulsory and discrete. Remember that this report and its recommendations were endorsed by the Council of Deans of Nursing and Midwifery. My colleague protested and appears to have been listened to, this time, but what about next time? The reality is that the quality and quantity of mental health nursing in undergraduate curricula is strongly related to the presence or absence of senior mental health nursing academics and the extent of their influence and ability to have their voices heard over and above others to ensure that mental health nursing is not ignored. I can't begin to count the number of times I have heard my peers talk about establishing a robust mental health nursing component, then changing jobs or going on extended leave, only to find it reduced to a mere shadow of what it had been. References to overcrowded curricula, specialization as a postgraduate issue, or in some cases, blaming mental health services for failure to provide positive learning experiences are merely excuses to mask the lack of commitment to mental health nursing and its importance for nursing practice. So what is the solution to this long-standing problem? I wish I had it. Not surprisingly, I have my own views, but the point I want to make here is that mental health nurse academics cannot do this on their own. They are small in number in most Australian universities, and unless they hold senior positions, their influence is likely to be minimal. Partnership and support from mental health services might not be an instant solution, but it is sure to help. It is important to work together to maximize influence. Clinicians, managers, and educators can help the cause by working with the university academics, sitting on key committees, teaching into academic programmes, and ensuring high-quality clinical placements, to mention a few possibilities. By developing strong collaborations, let's hope we can have more positive discussions about undergraduate mental health nursing in the future.