Jacquie White

Role of the mental health nurse towards physical health care in serious mental illness: An integrative review of 10 years of UK Literature

People with serious mental illness have significantly poorer physical health compared to the general population. Mental health nurses are in a prime position to help reduce unacceptable death in this population. A literature search was undertaken to identify the role of the mental health nurse in regards to physical health care, intervention, and attaining the necessary knowledge to address the physical health needs of people in the UK with serious mental illness. Of 254 papers identified, nine met the inclusion criteria. An integrative literature review found that mental health nurses are not routinely supported by physical health-care education and training, with many expressing role ambiguity. Inpatient setting correlated to a less positive role attitude; poor primary-secondary care interface communication compounded the problem of this vulnerable population having their physical health needs identified and met.

Enhancing medication adherence in people with schizophrenia: An international programme of research

This paper describes the development of an adherence therapy intervention in schizophrenia and synthesizes the results to date of a collaborative international programme of research. Sticking to treatment is essential to control symptoms and prevent relapse, but as with other long-term conditions, medication adherence is poor. Adherence therapy seeks to facilitate a process of shared decision making, where both parties work towards agreed goals. Central is the theory that when patients make shared choices with a professional they are more likely to stick with them because they are personally owned and meaningful. The results of adherence therapy trials that seek to test this theory are mixed. Outcomes of trials might have been be affected by the point in the patients illness cycle when therapy was delivered and by sampling bias. Authors of trials of medication management and alliance training packages that aim to equip mental health workers with adherence therapy competencies show considerable promise in improving clinical outcomes. Helping patients manage their medication is central to the work of mental health nurses. We argue that the potential benefits to patients are such that there is sufficient evidence to recommend that all mental health nurses receive medication management training.

The development of the serious mental illness physical Health Improvement Profile

WHITE J., GRAY R. & JONES M. (2009) Journal of Psychiatric and Mental Health Nursing16, 493-498 The development of the serious mental illness physical Health Improvement ProfilePeople with serious mental illness (SMI), such as schizophrenia and bipolar disorder, are more likely to suffer from a range of long-term physical conditions including diabetes and cardiovascular disease. Consequently they will die 10-15 years earlier than the general population. Health services have failed to address this major health inequality because of a lack of consensus about the type and frequency of monitoring people with SMI require and a lack of knowledge and skills in the mental health workforce. We developed the SMI physical Health Improvement Profile to help mental health nurses profile the physical health of the SMI patients they work with and direct them towards the evidence base interventions available to address identified health problems.

The future of mental health nursing: are we barking up the wrong tree?

This commentary has been prompted by a degree of disquiet among the UK mental health nursing community in response to the Shape of Caring Review on the future of nurse education in England (Willis 2015). Proposals for the structure of nurse education have been interpreted as emphasizing generic at the expense of field-specific (e.g. mental health) education, with much specialist training beyond the scope of pre-registration courses (Lintern 2014, Middleton 2015). Specifically, there is a suggestion that student nurses will not enter their specialized field until completing two years of more generalist learning; reminiscent of the previous Project 2000 approach, criticized for supposed inadequate preparation of mental health students because general adult nursing dominated curriculum and teaching (UKCC 1999).

The Medicine with Respect Project: A stakeholder focus group evaluation

The administration of medicines is a role that fundamentally impacts on the wellbeing of the patient and has been described as one of the highest risk activities that a nurse undertakes. This article reports on the Medicine with Respect Project where collaborating organisations sought to improve the education and training of Mental Health Nurses toward safe and competence practice. Focus groups were used to evaluate stakeholders experiences and what emerged was overall satisfaction but with specific suggestions in how to improve the effectiveness of the project. All groups emphasised that all nurses in administering medicines should undergo a rigorous assessment of their medicines administration performance. This would make the ultimate aim of competent and safe practice more achievable.

Recovery from psychosis: physical health, antipsychotic medication and the daily dilemmas for mental health nurses

This paper considers some of the dilemmas experienced by Mental Health Nurses everyday when faced with the seemingly conflicting relationships that exist between recovery, antipsychotics and the physical health of people experiencing psychosis. We examine the role of antipsychotics in the process of recovery from psychosis and argue that Mental Health Nursing’s laudable shift away from the medical model towards the concept of self-defined personal recovery should not result in overlooking the importance of physical health and medication management. Mental Health Nurses have a responsibility to help services users make an informed choice about treatment; this exchange of information should be based on the best available evidence rather than philosophical values or personal opinion.

Partial agonists and schizophrenia: theoretical developments for the development of mental health nursing

People with schizophrenia have a significant impaired quality of life. The paper discusses how partial agonists could improve the quality of life with people with schizophrenia in comparison with treatment with second generation antipsychotics. The paper provides a framework as to how mental health nurses can utilize the clinical benefits of partial agonists through greater application of psychosocial interventions.