The activities that nurses working in community mental health perform: a geographical comparison
Brenda M. Happell A B E , Cadeyrn J. Gaskin A B , Wendy Hoey C , Debra Nizette D and Kate Veach DA Central Queensland University, Institute for Health and Social Science Research, Bruce Highway, Rockhampton, Qld 4702, Australia.
B Centre for Mental Health Nursing Innovation, Bruce Highway, Rockhampton, Qld 4702, Australia. Email: c.gaskin@cqu.edu.au
C Central Queensland Mental Health Service, Rockhampton, Qld 4700, Australia. Email: wendy_hoey@health.qld.gov.au
D Nursing and Midwifery Office, Level 3, Forestry House, Mary Street, Brisbane, Qld 4000, Australia. Email: debra_nizette@health.qld.gov.au; kate_veach@health.qld.gov.au
E Corresponding author. Email: b.happell@cqu.edu.au
Australian Health Review 37(4) 453-457 https://doi.org/10.1071/AH13045
Submitted: 17 February 2013 Accepted: 24 April 2013 Published: 14 June 2013
Abstract
Objective. The primary aim of the present study was to identify the activities that nurses in community mental health services undertake.
Method. A dataset containing records of the community and ambulatory interventions involving the nursing staff of 252 mental health facilities was analysed.
Results. Nurses spend most of their time performing clinical care (78%), followed by clinical organisation (12%), mental health administration (6%) and integration activities (4%). There were minimal differences between treating units located in metropolitan, rural and remote areas in terms of the numbers of consumers receiving care, the time nurses spent with consumers, the types of nursing activities undertaken and the amounts of time spent on each of the four types of nursing activities.
Conclusions. These findings suggest that nurses in mental health community settings spend more time in clinical care than nurses in other healthcare settings.
What is known about the topic? Community settings are increasingly becoming the primary focus for mental health care in Australia. Nurses are providing community-based care for consumers with increased levels of acuity. There is a paucity of documented evidence about the activities nurses perform in community mental health settings.
What does this paper add? This study provides a comprehensive understanding of the activities undertaken by nurses in community mental health settings. The findings presented emphasise the high proportion of clinical care performed by nurses in community mental health settings. No significant differences were noted in the provision of clinical care between metropolitan, rural and regional mental health services.
What are the implications for practitioners? A comprehensive understanding of the activities of nurses in community mental health settings provides the basis for understanding the important role nursing plays in this area of care delivery.
Additional keywords: clinical care, community mental health, mental health services, nurses, nursing activities.
References
[1] Hamden A, Newton R, McCauley-Elsom K, Cross W. Is deinstitutionalization working in our community? Int J Ment Health Nurs 2011; 20 274–83.| Is deinstitutionalization working in our community?Crossref | GoogleScholarGoogle Scholar | 21450048PubMed |
[2] Muir-Cochrane E. The case management practices of community mental health nurses: ‘doing the best we can’. Aust N Z J Ment Health Nurs 2001; 10 210–20.
| The case management practices of community mental health nurses: ‘doing the best we can’.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD3Mnlt1Wisg%3D%3D&md5=193b2e1168ad911e9facfd63ce29b187CAS | 11703271PubMed |
[3] Happell B, Hoey W, Gaskin CJ. Community mental health nurses, caseloads, and practices: a literature review. Int J Ment Health Nurs 2012; 21 131–7.
| Community mental health nurses, caseloads, and practices: a literature review.Crossref | GoogleScholarGoogle Scholar | 22034873PubMed |
[4] Australian Institute of Health and Welfare. Mental health services in Australia 2007–08. Mental health series no. 12. Cat. no. HSE 88. Canberra: Australian Institute of Health and Welfare; 2010.
[5] Department of Health and Ageing. National mental health report 2010: summary of 15 years of reform in Australia’s mental health services under the National Mental Health Strategy 1993–2008. Canberra: Commonwealth of Australia, 2010.
[6] Australian Health Ministers. National mental health plan. Canberra: Australian Government Publishing Service; 1992.
[7] Henderson J, Willis E, Walter B, Toffoli L. Community mental health nursing: keeping pace with care delivery? Int J Ment Health Nurs 2008; 17 162–70.
| Community mental health nursing: keeping pace with care delivery?Crossref | GoogleScholarGoogle Scholar | 18460077PubMed |
[8] Jacobs S, Hughes J, Challis D, Stewart K, Weiner K. Care managers’ time use: differences between community mental health and older people’s services in the United Kingdom. Care Manag J 2006; 7 169–78.
| Care managers’ time use: differences between community mental health and older people’s services in the United Kingdom.Crossref | GoogleScholarGoogle Scholar | 17194053PubMed |
[9] Ng DT-F, Chan SWC, MacKenzie A. Case management in the community psychiatric nursing service in Hong Kong: Describing the process. Perspect Psychiatr Care 2000; 36 59–66.
| 1:STN:280:DC%2BD383psVKquw%3D%3D&md5=5bd8def61d6e6ae5853be8fa493d6de9CAS |
[10] Jones K, Duncan C. Individuals and their ecologies: Analysing the geography of chronic illness within a multilevel modelling framework. Health Place 1995; 1 27–40.
| Individuals and their ecologies: Analysing the geography of chronic illness within a multilevel modelling framework.Crossref | GoogleScholarGoogle Scholar |
[11] Goddard M, Smith P. Equity of access to health care services: theory and evidence from the UK. Soc Sci Med 2001; 53 1149–62.
| Equity of access to health care services: theory and evidence from the UK.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD3MrgvVSjtQ%3D%3D&md5=7472e1f72f71c869c6acefc60feb1274CAS | 11556606PubMed |
[12] Australian Institute of Health and Welfare. Rural, regional and remote health: indicators of health status and determinants of health. Rural Health Series no. 9. Cat. no. PHE 97. Canberra: Australian Institute of Health and Welfare; 2008.
[13] Australian Institute of Health and Welfare. Rural, regional and remote health: indicators of health system performance. Rural Health Series no. 10. Cat. no. PHE 103. Canberra: AIHW; 2008.
[14] Beebe L, Adams S, El-Mallakh P. Putting the ‘evidence’ in evidence-based practice: meeting research challenges in community psychiatric settings. Issues Ment Health Nurs 2011; 32 537–43.
| Putting the ‘evidence’ in evidence-based practice: meeting research challenges in community psychiatric settings.Crossref | GoogleScholarGoogle Scholar | 21767256PubMed |
[15] Happell B, Hoey W, Gaskin CJ. The characteristics of consumers receiving case management in the community: a review of literature. Issues Ment Health Nurs 2012; 33 145–8.
| The characteristics of consumers receiving case management in the community: a review of literature.Crossref | GoogleScholarGoogle Scholar | 22364425PubMed |
[16] Watts I, Foley E, Hutchinson R, Pascoe T, Whitecross L, Snowdon T. General practice nursing in Australia. Melbourne: Royal Australian College of General Practitioners & Royal College of Nursing, Australia; 2004.
[17] Department of Primary Industries and Energy, Department of Human Services and Health. Rural, remote and metropolitan areas classification: 1991 Census edition. Canberra: Australian Government Publishing Service; 1994.
[18] Department of Health and Ageing. Mental health national outcomes and casemix collection: technical specification of state and territory reporting requirements, version 1.60. Canberra: Department of Health and Ageing; 2009.
[19] Hochberg Y. A sharper Bonferroni procedure for multiple tests of significance. Biometrika 1988; 75 800–2.
| A sharper Bonferroni procedure for multiple tests of significance.Crossref | GoogleScholarGoogle Scholar |
[20] Cohen J. Statistical power analysis for the behavioral sciences. 2nd ed. Hillsdale, NJ: Erlbaum; 1988.
