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  • How nurses can care for the mental health of people with chronic disease

    Author: Karen Keast

There is no health without mental health - that’s the view of the World Health Organisation. Now, the Australian College of Mental Health Nurses is launching online CPD aimed at improving the knowledge and skills of nurses to identify and manage mental health conditions associated with chronic disease, writes Karen Keast.

Poor mental health is not just an issue for mental health nurses.

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Research predicts every nurse, at some stage, will work with a patient who is either at risk of developing, has developed or is showing early signs and symptoms of mental illness.

Studies show many physical health conditions increase the risk of mental illness while poor mental health is also known to heighten the incidence of diseases such as cancer, heart disease and stroke.

Comorbidity of physical illness and mental health issues not only affects whether people seek help, it also impacts on their diagnosis and treatment, and influences both their physical and mental recovery.


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With the growing incidence of chronic disease in Australia, the Australian College of Mental Health Nurses (ACMHN) is shining the spotlight on improving the identification, early intervention, treatment and management of mental illness in people with a chronic physical illness.

And all nurses, not just mental health nurses, have an integral role to play.

With nurses at the grassroots of health care provision throughout rural and regional Australia and across all health settings, the ACMHN knows how vital it is to educate nurses about the comorbidity of mental illness and chronic disease, and to equip nurses with the knowledge and skills to identify and better manage patients with mental health issues.

“In a lot of ways, nurses are the gateway for people to receive mental health treatment,” says ACMHN professional development senior project officer Peta Marks.

“I think when we all learn about nursing and learn about holistic nursing, we understand there is that connection…but sometimes that can get a bit sidelined when you are working in a really busy place and focused on getting the job done - when you are looking after people’s physical needs.

“Looking after their mental health needs is a really important part of being a nurse.”

In the next few months, the ACMHN will launch its first series of online resources focused on chronic disease and mental health, which will enable nurses to attract continuing professional development points.

The free eLearning program will feature five 20-minute topics focused on the four chronic disease areas of cancer, cardiovascular disease, diabetes and respiratory disease.

The modules are aimed at providing nurses with the knowledge and the skills to identify and assess mental illness and mental issues in patients living with chronic diseases, support patients with chronic diseases to manage co-existing mental illness and mental health issues while maintaining good mental health.

The program will also help nurses to work effectively and collaboratively with patients, carers, other health professionals and service providers to provide integrated care to patients.

The expert reference group behind the program includes Commonwealth Chief Nurse and Midwifery Officer Dr Rosemary Bryant and representatives from the ACMHN, including CEO Kim Ryan, the Australian Diabetes Educators Association, National Mental Health Consumer and Carer Forum, Australian Practice Nurses Association, National Mental Health Consumer and Carer Forum, Australian Cardiovascular Nursing College, Congress of Aboriginal and Torres Strait Islander Nurses, Thoracic Society of Australia and New Zealand, CRANAplus and Cancer Nurses Society of Australia.

The steering committee also involves representatives from the Mental Health Professionals Association, Australian College of Nursing, ACMHN board and MHPOD (Mental Health Professional Online Development).

Ms Marks, who has worked in mental health nursing for more than 20 years and runs a small, private practice, says the online resources are unique, delivering a case-based program providing CPD developed by nurses for nurses.

The interactive program uses video vignettes with real nurses and simulated patients.

“The nurses involved in the expert reference group are all really excited about the project and feel it’s quite unique because it is case-based,” she says.

“They believe it’s going to be really well targeted towards the nursing audience.”

Ms Marks says the program, which was discussed at the recent ICN Congress held in Melbourne, has already generated interest and the college hopes to attract 10,000 nurses to the program in its first year.

“I would be thrilled if we were inundated by nurses wanting to do the program,” she says.

“Mental health is something that every nurse needs to know about.

“We don’t expect comprehensively trained nurses to be experts in mental health but everyone does have a responsibility to know the basics to identify someone who might be at risk of developing mental health issues.”

Ms Marks says the health outcomes of comorbid mental health conditions, such as anxiety and depression, for people living with chronic disease include higher morbidity rates, a lower quality of life, fewer healthy behaviours, while it is also much more difficult for the person’s carers and family members to cope with dual issues.

“Picking up on mental health issues early makes a huge difference in terms of outcome, particularly in patients with chronic disease,” she says.

“Sometimes mental health is related to the biology of what’s happening but mostly it’s related to what the person is experiencing.

“One of the difficulties is trying to work out where normal sadness or worries about chronic disease end and where those mental health problems begin.

“Just because you have got cancer doesn’t mean you should be depressed. It’s really important to know those two things don’t necessarily go hand in hand.”

Ms Marks says she hopes the program will give nurses the confidence to raise some simple aspects of mental health with their patients, and provide nurses with skills they can use in a variety of situations, such as talking to someone who is agitated.

“It’s giving nurses the confidence to deal with that in a professional way that helps to contain the situation and helps to decrease the person's anxiety so that it doesn’t escalate into a crisis,” she says.

“These are skills that we all use every day and we all need every day. There’s no invisible line between people who have mental health issues and the rest of us.

“It’s all about communication and empathy and understanding the person and it’s something that people can use every day with every patient and every family.”

Ms Marks says it’s vital all nurses have an understanding about mental health.

“Whether you are working in an ED or a general ward or a cancer ward, mental health is a huge part of what all nurses should be able to do,” she says.

“Nurses can flag the issues and make an appropriate referral, and the person can be helped with their experiences before it becomes a major mental health problem.”

For more information visit the ACMHN’s CPD portal.


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Karen Keast

Karen Keast is a freelance health journalist who writes news and feature articles for HealthTimes.

Karen regularly writes for some of Australia’s leading health news websites and magazines.  In a media career spanning 20 years, Karen has worked as a senior journalist in newspapers and television. She has covered the grind of daily news and worked as a politics reporter at countless state and federal elections.

Since venturing into freelance writing five years ago, Karen has found her niche in writing about the health sector for editors, businesses and corporations.

Karen has interviewed the heads of peak health organisations in Australia and overseas, and written hundreds of news and feature articles covering the dedicated work of health professionals who tread the corridors of hospitals and health services, universities, aged care facilities and practices, day in and day out.

Follow Karen Keast on Twitter @stylemywords