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O'Brien, A. J., Hughes, F., & Kidd, J. D. (2006). Mental health nursing in New Zealand primary health care. Contemporary Nurse, 21(1), 142–152.
Abstract: This article describes the move in mental health from institutional care to community arrangements. It draws on international literature and New Zealand health policy, which gives increased emphasis to the role of the primary health care sector in responding to mental health issues. These issues include the need for health promotion, improved detection and treatment of mild to moderate mental illness, and provision of mental health care to some of those with severe mental illness who traditionally receive care in secondary services. These developments challenge specialist mental health nurses to develop new roles which extend their practice into primary health care. In some parts of New Zealand this process has been under way for some time in the form of shared care projects. However developments currently are ad hoc and leave room for considerable development of specialist mental health nursing roles, including roles for nurse practitioners in primary mental health care.
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Crowe, M., Ward, N., Dunnachie, B., & Roberts, M. H. (2006). Characteristics of adolescent depression. International Journal of Mental Health Nursing, 15(1), 10–18.
Abstract: This is a descriptive study of the characteristics of depression in a sample of 121 adolescents attending an outpatient specialist adolescent mental health service in New Zealand. The adolescents were required to complete two self-report measures to assess presence of depressive symptoms, severity of depression, and particular characteristics of the depression. The findings revealed that irritability was the most common characteristic along with other interpersonal and thought processing symptoms. It is important that mental health nurses are able to identify the specific characteristics of adolescent depression that may differ from adult depression in order to manage this patient population effectively.
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Crowe, M., & Luty, S. (2005). Recovery from depression: A discourse analysis of interpersonal psychotherapy. Nursing Inquiry, 12(1), 43–50.
Abstract: This paper describes a discourse analysis of the process of interpersonal psychotherapy (IPT) in the recovery from depression. It demonstrates how IPT is an effective treatment strategy for mental health nurses to utilise in the treatment of depression. The discourse analysis highlights how the development of more meaningful subject positions enables one woman to recover from her depression. The process of recovery is underpinned by an understanding of women's depression as promoted by contemporary social and cultural expectations for detachment and reflexivity. This paper shows how IPT provides an opportunity for recovery from depression for one woman by facilitating a reconstruction of her subject positions in relation to others. The discourse analysis revealed that the therapist facilitated this through the use of a range of techniques: seeking information, exploring beliefs/values/assumptions, exploring communication patterns, exploring affective responses and exploring alternative subject positions.
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Palmer, S. G. (2003). Application of the cognitive therapy model to initial crisis assessment. International Journal of Mental Health Nursing, 12(1), 30–38.
Abstract: This article provides a background to the development of cognitive therapy and cognitive therapeutic skills with a specific focus on the treatment of a depressive episode. It discusses the utility of cognitive therapeutic strategies to the model of crisis theory and initial crisis assessment currently used by the Community Assessment & Treatment Team of Waitemata District Health Board. A brief background to cognitive therapy is provided, followed by a comprehensive example of the use of the Socratic questioning method in guiding collaborative assessment and treatment of suicidality by nurses during the initial crisis assessment.
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Crowe, M., O'Malley, J., & Gordon, S. (2001). Meeting the needs of consumers in the community: A working partnership in mental health in New Zealand. Journal of Advanced Nursing, 35(1), 88–96.
Abstract: The aim of this study was to evaluate whether the services that community mental health nurses provide are meeting the needs of consumers in the community. This was a joint project between nurses and consumers. It was a service-specific descriptive research project utilising qualitative methods of data collection and analysis that provides a model for working in partnership. The results of this research identify collaboration in planning care and sharing information as two areas of concern but generally the consumers were very satisfied with the care provided by community mental health nurses. The analysis of the data suggests that consumers value nursing care because nurses provide support in their own home; they help consumers develop strategies for coping with their illness and their life; they provide practical assistance when it is required; they are vigilant about any deterioration or improvement; and they are available and accessible. The results of this study have demonstrated that nurses will remain critical to the success of community-based care because of their ability and willingness to be flexible to the demands of their own organisation and the users of services.
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Wiffin, L. (2006). Treating depression during pregnancy: Cognitive behavioural therapy as a treatment option. Available online from Eastern Institute of Technology, 14(1), 8–12.
Abstract: This article reviews the use of cognitive behavioural therapy (CBT) for pregnant women suffering from depressive symptoms. CBT provides a structured, short-term, collaborative process between clinician and client, using strategies and techniques to identify dysfunctional thinking and beliefs, challenge and change these beliefs, then implement new rational beliefs and behaviours. A process of engagement, assessment and conceptualisation is followed by treatment planning and implementation, and modification of dysfunctional thinking and behaviours. Use of CBT to treat depression in women during pregnancy is supported by the literature, especially where pharmacological intervention is declined or contraindicated. Pregnancy can bring stressors that combine with biological factors and core beliefs to contribute to depressive symptoms.
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Ledesma-Libre, K. (2019). Factors influencing nurses' choice to work in mental health services for older people. Kai Tiaki Nursing Research, 10(1), 61–62.
Abstract: Explores what influences nurses to work in mental health services for older people (MHSOP)and what factors encourage those who did not choose this area of nursing, to continue in MHSOP. Includes nurses' positive and negative perceptions of MHSOP. Collects data via focus group discussions with 30 mental health nurses.
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Weber, H. (2023). Deciding on a safe site for intramuscular injections in an acute mental health setting. Kaitiaki Nursing Research, 14(1), 58–61.
Abstract: Aims to provide practical guidance for health-care providers to ensure the safe and effective administration of intramuscular injections, when there is the potential for violence and agitation, as well as during personal restraint. Undertakes a realist review of the evidence comparing the dorsogluteal and ventrogluteal sites.
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McKenna, B., O'Brien, A. J., Dal Din, A., & Them, K. (2006). Responsible clinician role offers opportunities for nurses. Kai Tiaki: Nursing New Zealand, 12(11), 12–14.
Abstract: The authors report on a recent study investigating the statutory role of responsible clinician. Statutory roles under mental health legislation offer mental health nurses a means of having advanced practice skills recognised, as well as contributing to improved access to services. There is a proliferation of roles intended to develop nursing readership, but in most cases they are not primarily clinical roles. The concept of “advanced practice” has become a means of developing clinical leadership roles in nursing. Research on responsible clinician role is presented along with the results of a survey of the 11 Registered Nurses practicing as responsible clinicians, five senior nurses from each of the 21 district health boards, and the Auckland Regional Forensic Psychiatry Services (n = 121). Respondents were asked whether the responsible clinician role was a legitimate one for nurses and whether they were motivated to attain or maintain that role. They were also asked which competencies for the role they believed they met, their perceptions of credentialing processes and the educational requirements needed to achieve the role. A clear majority of the respondents felt the role of the responsible clinician was a legitimate advanced practice role for mental health nurses. Despite this, some respondents expressed ambivalence about taking on the role. The research highlighted deficits in knowledge and skills that could become a focus of education for advanced practitioners seeking appointment as responsible clinicians. Deficits included some assessment skills, knowledge of a range of interventions and knowledge of other legislation affecting mental health legislation.
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Mortensen, A., & Young, N. (2004). Caring for refugees in emergency departments in New Zealand. Nursing Praxis in New Zealand, 20(2), 24–35.
Abstract: This paper outlines some of the special health needs of people from refugee backgrounds who present in the emergency department, and the role of emergency department nurses in improving care for refugee and migrant peoples. Refugees and asylum seekers represent a significant proportion of attendees in emergency departments in Auckland Hospitals. Culture and ethnicity are a major factor to be considered in addressing the health care needs of this population. Other factors such as the physical and psychological sequelae of the refugee experience, health care experience prior to arrival in New Zealand, poverty, language, and the trauma of resettlement also have a major impact on health care seeking behaviours.
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Farrow, T., McKenna, B., & O'Brien, A. J. (2002). Initiating committal proceedings 'just in case' with voluntary patients: A critique of nursing practice. Nursing Praxis in New Zealand, 18(2), 15–23.
Abstract: The authors report a clinical audit that, combined with anecdotal evidence, verifies the practice of putting section 8B medical certificates on the files of voluntary mental health patients at the time of admission. This is seen as a strategy to balance the requirement to support and promote the autonomy of voluntary patients with the need to protect those patients or other people. A conceptual analysis of these issues indicates that such a practice is both legally questionable and ethically inappropriate. The authors suggest an alternative framework for practice that is legally and ethically preferable for both nurses and patients.
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Thompson, R., & Farrow, T. (1999). The Workbook Portfolio: Facilitating undergraduate student learning in the mental health clinical area. Nursing Praxis in New Zealand, 14(2), 21–30.
Abstract: This article describes the use of a model that has been developed to assist students in tackling the complex issues surrounding mental health nursing. The Workbook Portfolio has identifiable components that encourage the development of reflective and analytical skills, which allow nurses to practice within an environment that is influenced and determined by a complex, and sometimes contradictory, range of external influences. The article explains the workings of this model so it can be used by educators to for students in the mental health setting.
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Nicol, M. J., Manoharan, H., Marfell-Jones, M., Meha-Hoerara, K., Milne, R., O'Connell, M., et al. (2002). Issues in adolescent health: A challenge for nursing. Contemporary Nurse, 12(2), 155–163.
Abstract: This review provides an overview of the health issues for adolescents, and the implications for nursing practice, particularly around health promotion. It looks at the social context of adolescents including peer pressure, along with health issues such as suicide, mental health, sexual health, and smoking.
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Farrow, T. (2003). 'No suicide contracts' in community crisis situations: A conceptual analysis. Journal of Psychiatric & Mental Health Nursing, 10(2), 199–202.
Abstract: 'No suicide contracts' take the form of a 'guarantee of safety', along with a 'promise' to call specified persons if the suicidal ideation becomes unmanageable for the person concerned. They are commonly used in community crisis situations with suicidal people in New Zealand. This article describes and analyses the use of 'no suicide contracts' in these settings. It is argued that the theoretical base (transactional analysis) of the 'no suicide contract' is likely to be deleterious in the community crisis situation.
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Crowe, M. (2002). Reflexivity and detachment: A discursive approach to women's depression. Nursing Inquiry, 9(2), 126–132.
Abstract: This paper explores a discursive approach to understanding women's depression by presenting the results of research into women's narratives of their experiences. The discursive approach taken acknowledges women's immersion in cultural practices that determine the subject positions available to them and places a value on attributes of reflexivity and detachment that are not usually associated with their performance. The social and cultural context of the individual's experience is significant because if the focus is simply on the individual this supposes that the problem lies solely with the individual. An understanding of cultural expectations and their relation to mental distress is important to mental health nursing practice. The psychotherapeutic relationship that is fundamental to mental health nursing practice requires an understanding of the meaning of individual's responses in their cultural context in order to provide facilitative and meaningful care for the women that they nurse.
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