Mental Health Nurse Practitioner Role Research Articles

Mental health nursing in emergency departments: the case for a nurse practitioner role

This paper aims to explore the effectiveness of the mental health nurse practitioner role in the emergency department in the context of the growing use of special units or segregated areas to manage particular kinds of mental health presentations, often complicated by substance use. In recent years, there has been a significant increase in mental health presentations to emergency departments, often complicated by substance abuse. Emergency departments have introduced a variety of mechanisms to address this growing problem. With the introduction of mental health nurse practitioners, opportunities arise to reconsider these mechanisms. Discursive paper. In this discursive paper, contemporary practices are described in relation to 'special care areas', 'psychiatric emergency centres' and 'short-stay units'. The mental health nurse practitioner role in training and capacity building is also explored and the notion of 'locational processes' described. Rather than being presented as an alternative to short-stay units, the mental health nurse practitioner role is explored in its potential to enhance mental health nursing practice in a sometimes difficult clinical environment. The paper provides evidence from literature and practice that the clinical outcome for consumers is enhanced through the mental health nurse practitioner role. It is argued that the introduction of the mental health nurse practitioner role in the emergency department leads to increased staff competence and confidence in interacting with those presenting with mental health issues. The mental health nurse practitioner role also addresses the serious problem of stigma associated with those with a mental health issue. It is expected that those presenting with mental health issues to the emergency department will benefit through the increased assessment and management skills of staff.

Exploring the mental health nurse practitioner scope of practice in youth early psychosis: An anecdotal account

The development of the Victorian mental health nurse practitioner youth early psychosis, is a pioneer advance in clinical psychiatric/mental health nursing. This paper will explore and describe the scope of practice for the youth early psychosis mental health nurse practitioner candidate, and how the model is informed by relevant literature. The role description and context of the nurse practitioner candidate, which is synonymous with the role of the endorsed nurse practitioner, is described. Advanced practice nursing is discussed in terms of what the nurse practitioner literature says and contrasted with perceptions of a clinical nurse’s everyday practice.Inherent challenges and issues are highlighted that need to sit in the background of any picture being painted of the mental health nurse practitioner role in Victoria into the future. An alternative perspective in the mental health care of the young person is proposed for the nurse practitioner scope of practice.

Refining the model for an emergency department‐based mental health nurse practitioner outpatient service

The mental health nurse practitioner (MHNP) role based in the emergency department (ED) has emerged in response to an increase in mental health-related presentations and subsequent concerns over waiting times, co-ordination of care and therapeutic intervention. The MHNP role also provides scope for the delivery of specialised primary care. Nursing authors are reporting on nurse-led outpatient clinics as a method of healthcare delivery that allows for enhanced access to health-care, particularly following hospital discharge. However, due to a lack of in-depth substantiation, this mode of service delivery requires more thorough investigation. This study describes the refinement phase undertaken before the implementation and pilot evaluation of a formalized and structured MHNP outpatient service in the ED of a large inner-city hospital in Sydney, Australia. An expert advisory panel (EAP) consisting of key local informants was convened to provide feedback on and refinement to the proposed model. This related to issues such as target population, structure and process considerations, outcome measures and interface within the overall health service. Findings from the EAP meeting are presented and discussed. The importance of linking methods with the appropriate methodology in evaluating a healthcare program is highlighted.

Exploring the scope of the Emergency Department mental health nurse practitioner role

The mental health nurse practitioner (MHNP) role in the Emergency Department is focused on assessing and intervening to assist people in mental distress. The skills and expertise associated with this role are also compatible with the provision of short-term outpatient care. This scoping study investigated the potential for a MHNP outpatient service for patients presenting through the Emergency Department with a range of undifferentiated mental health concerns. The specific aim of this study was to explore the feasibility, structure, and potential outcome measures that may be used to evaluate a MHNP outpatient service. Data for the study were gathered via an extensive literature review and two separate focus group interviews. A series of semistructured interviews conducted with key informants were also undertaken to incorporate a range of clinical, academic, health manager, consumer, and carer perspectives. Findings from the study including prospective benefits and barriers associated with the implementation of this new service are highlighted and discussed. These findings indicate that a structured and formalized MHNP outpatient service has the potential to address a current deficit in the health-care system by providing timely, accessible, primary prevention, and early intervention mental health care that better meets the needs of the public and is consistent with the Australian National Mental Health Plan (2003-2008). A MHNP outpatient service also provides an important opportunity to explore, expand, and more clearly define the unique and valuable contribution of advanced mental health nursing practice to contemporary health care.

Examining Models of Mental Health Service Delivery in the Emergency Department

The purpose of the present paper was to review the current models of mental health service delivery used in the emergency department (ED) setting. A search was conducted of the nursing and medical literature from 1990 to 2007 for relevant articles and reports. Consideration was also given to the global and local context influencing contemporary mental health services. Wider sociopolitical and socioeconomic influences and systemic changes in health-care delivery have dictated a considerable shift in attention for mental health services worldwide. The ED is a topical location that has attracted interest and necessitated a response. The mental health liaison nurse (MHLN) role embedded within the ED structure has demonstrated the most positive outcomes to date. This model aims to raise mental health awareness and address concerns over patient-focused outcomes such as reduced waiting times, therapeutic intervention and more efficient coordination of care and follow up for individuals presenting to the ED in psychological distress. Further research is required into all methods of mental health service delivery to the ED. The MHLN role is a cost-effective approach that has gained widespread approval from ED staff and mental health patients and is consistent with national and international expectations for mental health services to become fully integrated within general health care. The mental health nurse practitioner role situated within the ED represents a potentially promising alternative for enhanced public access to specialized mental health care.

Progression of the mental health nurse practitioner role in Australia

The guiding principle of health care is to serve the needs of the public. Healthcare services are therefore required to be increasingly flexible and open to new approaches to meet changing demands. They must also adjust and expand as new challenges are presented. Public awareness of mental health issues and the current demands placed on health services for access to affordable and appropriate mental health care have never been so great. The introduction of nurse practitioners (NPs) in Australia is a proud and long-anticipated moment for the discipline of nursing. However, a major challenge for the introduction of NPs in Australia will be to reassure medical colleagues, allied health professionals and the public that NPs are able to deliver high-quality primary care. This paper elaborates on the progress of the mental health NP role in Australia. Attention is centred on the characteristics the mental health NP role, the maintenance of professional competency to practise at an advanced clinical level, and the prospects and potential significance of NPs for mental health nursing practice. The nurse-led clinic, implemented through the process of consultation and systematic evaluation, is identified as an avenue for the extension of mental health NP practice in the delivery of autonomous primary care.