I am a mental health nurse (credentialed), presently employed as a lecturer at Dublin City University. My recent posts were in Townsville (Australia) where I was a team leader for a homelessness outreach team, clinical nurse consultant on a community team and a mobile intensive treatment team, and for a year was a researcher/project officer. Prior to this I worked as a senior lecturer at the Eastern Institute of Technology in Hawke's Bay, New Zealand. My clinical experience, research and teaching has largely been in the field of psychiatric and mental health nursing. I have worked in a large rural psychiatric hospital (all areas), regional in-patient units and a day hospital. I have taught and co-ordinated papers at both under-graduate and post-graduate / registration level. Teaching areas have included clinical mental health nursing, research, sociology, clinical teaching and pharmacology. Current research interests include exploring how people cope with 'hearing voices', the use of computer mediated communication in clinical practice, psychotherapy, assertive community treatment and community development.

I have a commitment to the field of psychiatric and mental health nursing and an interest in promoting this rewarding and challenging career via the internet. I am currently a member of my local health services ethics committee and recently a member of the Australian Health Ethics Committee Training Sub-Committee.

I regularly contribute to e-mail discussion about professional issues.

Click here to search the archives of the international psychiatric nursing list.

Contents
Qualifications	Journal articles	Book reviews & commentary	Contributions to books	Conference presentations	On-line documents

 

Lakeman, R. (2008). Book Review: Alternatives Beyond Psychiatry. Mental Health Practice, 11(8), 22-23.

Lakeman, R., & McGowan, P. (2008). Book Review: Handbook of Psychosocial Rehabilitation. Journal of Psychiatric and Mental Health Nursing, 15(5), 436-438.

Lakeman, R. (2008). Book Review: The Age of Melancholy: 'Major Depression' and its Social Origins. Journal of Psychiatric and Mental Health Nursing, 15(2), 172-173.

Lakeman, R. (2007). Book Review: 'Humanizing Psychiatry and Mental Health Care: The Challenge of the Person-centred Approach'. Journal of Psychiatric and Mental Health Nursing, 14, 827-829.

Lakeman, R. (1999). Book reviews: 'Mental Health Law in New Zealand'. Australian and New Zealand Journal of Mental Health Nursing, 8(5), 118-119.

Lakeman, R., & Williams, B. (1999). There are real impediments to funding nursing research... Barbara Williams... her role as "research co-ordinator". Kai Tiaki: Nursing New Zealand, 5(6), 3-4.

Lakeman, R. (1997). Looking back on '96. KaiTiaki: Nursing New Zealand, 2(11), 21.

On a personal level 1996 has been an exciting, challenging  and tumultuous year. The birth of our second child, Amelia followed closely by the death of my father in law have both been highlights in different ways  - reinforcing the preciousness and fragility of life. Both events involved encounters with health professionals which helped ease the way through these life passages for myself and my family....

Lakeman, R. (1997). Getting the most out of the internet. Nursing Informatics New Zealand: Newsletter, 6(5), 5-6.

Lakeman, R. (2003). Ethical issues in psychiatric and mental health nursing. In P. Barker (Ed.), Psychiatric and Mental Health Nursing: The Craft of Caring. (pp. 504-514). London: Arnold..

Lakeman, R. (1999). Commentary on 'Where care meets treatment: common ethical conflicts in psychiatric nursing'. In P. Barker (Ed.), The philosophy and practice of psychiatric nursing (pp. 213-216). Edinburgh: Churchill Livingstone.

Barker’s (1995) article proposes that there is an ethical dimension to the everyday decisions which psychiatric nurses make in everyday practice. Few would argue with this position and this commentary doesn’t.  Instead it proposes a complimentary case for values clarification by nurses as the first step to ‘being alive’ to such dimensions. It suggests that the first step in this process is acknowledging, and productively channelling the tension arising from value conflict in everyday practice. It is from such work that nursing can begin to establish substantive practice based moral positions....

Lakeman, R. (1999). Case Study 4: A cognitive behavioural approach to anxiety. In P. J. Barker (Ed.), Talking cures: a guide to the psychotherapies for health care professionals (pp. 59-64). London: Nursing Times Books.

.... Nursing can be therapeutic in it’s own right and definitions of nursing proposed by nurse theorists (particularly with backgrounds in mental health) hint at, or are explicit about the therapeutic potential of a nursing interaction. To realise this potential nurses draw on a wide range of theory and research, wedded to, and master of no one particular theoretical framework or model....

Lakeman, R., & Curzon, B. (1997). Society, disturbance and mental illness. In P. Barker & B. Davidson (Eds.), Ethical Strife (pp. 26-38). London: Arnold.

This chapter deals with the construction of dangerousness. It balances intrapsychic and social interpretations of what makes people violent and asks to what extent 'dangerousness' is in the eye of the beholder. It shows what a compromised position nurses are in trying to balance control and care against the backdrop of all sorts of barely compatible pressures and influences: professional, legal, social, political and ethical. Clinical case study material provides specific illustrations of the particular challenges faced by nurses working in the prison setting.

Contents
Qualifications	Journal articles	Book reviews & commentary	Contributions to books	Conference presentations	On-line documents

 

Lakeman, R. (2007, 10-12 Sep). Ordinary psychotherapy with extraordinary experience (Workshop). Paper presented at the Thinking, Feeling, Being: Critical Perspectives and Creative Engagement in Psychosocial Health, Dublin City University, Ireland.

People who may be considered 'psychotic', 'disordered' or 'deluded' are often excluded from formal psychotherapy. Nevertheless, the everyday interactions between people can be helpful and therapeutic. This workshop focuses on introducing and practicing a basic model of empathic communication at the supportive end of the psychotheraputic continuum that might be employed when people express bizarre or contrary ideas.

Lakeman, R. (2007, 10-12 Sep). Surviving being suicidal: What money can't buy and statistics can't tell us. Paper presented at the Thinking, Feeling, Being: Critical Perspectives and Creative Engagement in Psychosocial Health, Dublin City University, Ireland.

Increasing prosperity has not led to a reduction in suicide in most countries and neither has investment in epidemiological / risk factor focused research. Suicide is a pressing public policy issue and social concern but it also reflects an intensely personal struggle. This paper presents a review of the very limited literature examining the suicidal experience from the point of view of the suicidal person. It considers how people live with being suicidal.

Click here for multimedia presentation

Walsh, J., McGowan, P., & Lakeman, R. (2007, 10-12 Sep). I had a dream (but I got committee membership): authority, representativeness, collusion and protest in the service user movement. Paper presented at the Thinking, Feeling, Being: Critical Perspectives and Creative Engagement in Psychosocial Health, Dublin City University, Ireland.

The user movement is commonly understood to have been formed during the 1960s. At the heart of the movement was human rights and the deinstitutionalisation of the so called ‘mentally ill’. Like all social movements the mental health user movement has experienced various transformations over time. User involvement is now a relatively common occurrence in the drawing up of policy and legislative documents, in the planning and development of mental health services and research projects. These advances are primarily attributable to the user movement. Indeed, we now have service users asked to present at major mental health conferences, carrying out their own research projects and running their own services with some individuals reaching the dizzy heights of becoming authors of academic papers and books. The audience will be encouraged to reflect on the user movement, its legacy and transformative processes. The three presenters will be challenging participants to think critically about the current state of the user movement and ‘what it has become’. For example, has user involvement become a means by which services control the social agenda originally set out by the user movement? Has a hierarchy of service users developed mirroring that which exists within mental health services? Consequently, has the social status and levels of freedom for those deemed mentally ill improved since the 1960s? The presenters will address these controversial issues. Debate and dialogue with the audience to critically examine this will follow.

Lakeman, R. (2006, 30 Aug - 1 Sep). Enhancing family & carer participation in mental health care: The impact of practice standards. 16th Annual TheMHS Conference: Reach Out - Connect. Townsville Convention Centre Townsville, North Queensland, Australia

Abstract: The National Standards for Mental Health Services (Commonwealth of Australia, 1996) mandate the participation of consumers and carers in the development and evaluation of mental health services, and as partners in the process of care planning and evaluation. Yet recent reports continue to highlight that family members and carer’s feel excluded from mental health care (Mental Health Council of Australia, 2005. In late 2004 Townsville Institute of Mental Health introduced practice standards (TIMHS, 2004), or minimum expectations regarding communication and information sharing with family and carers as policy in adult in-patient and community services. This paper describes the promotion and evaluation of these standards and observations from consumers and carers about what is important to them in relation to participation. The adoption of practice standards appears to be a simple and cost effective means of enhancing mental health care.

Commonwealth of Australia (1996). National Standards for Mental Health Services, Canberra
Mental Health Council of Australia (2005). Not For Service: Experiences of Injustice and Despair in Mental Health Care in Australia, Canberra
TIMHS. (2004). Practice Standards for Family / Carer Participation. Retrieved 23/2, 2006, from http://www.health.qld.gov.au/townsville/Documents/IMHS/Practice_Standards.PDF, Townsville

Lakeman, R. (2006, 30 Aug - 1 Sep). I am different hear me roar: A critical examination of trends towards standardised treatment and homogenised care. 16th Annual TheMHS Conference: Reach Out - Connect. Townsville Convention Centre Townsville, North Queensland, Australia

The discourses that compete to shape mental health service provision may broadly be divided into those that emphasise individual difference, diversity and mystery and those that emphasis sameness or homogeneity and predictability. Practices such as case-mix determination, standardised outcome measurement, and the standardisation of treatment are vigorously promoted within mental health services (see: Australian Mental Health Outcomes and Classification Network, 2004). The arguments for these are seductive. They promise certainty, meet managerial demands for more and better information, cement the role of health professional as expert and facilitate a certain kind of evidenced based practice. This paper raises questions about the compatibility of these practices and their underlying assumptions with the promotion of personal recovery, the notion of people and groups as complex, therapy as a process of discovery, and the stance of the health professional as one of humility. Discourse is created and perpetuated by those who have the power and means of communication (Foucalt, 1973). This paper argues that logic, reason and ‘evidence’ alone will not derail current trends towards managed and homogenised care. Real change may only happen when consumers, carers and compassionate health professionals present a loud enough counter-case and are heard and respected.

Foucalt, M (1973). The birth of the clinic:An archaeology of medical perception. New York: Pantheon
Australian Mental Health Outcomes and Classification Network. (2004). MHNOCC.ORG - Home. Retrieved 24/2, 2006, from http://www.mhnocc.org/

Lakeman, R. & Voss, M. (2005, 24-26 June). Encouraging positive family engagement. North Queensland Sub-Branch of the ANZCMHN 7th Annual Symposium. Magnetic Island Resort, Magnetic Island, QLD.

This paper provides an overview of findings and musings on a project to increase the quality of family and carer participation in adult mental health services. Research findings that particularly highlight the views of service users and family members will be highlighted.
Lakeman, R. (2005, 24-26 June). Reflecting on the medium and message: Technology, clinical supervision and mental health practice. North Queensland Sub-Branch of the ANZCMHN 7th Annual Symposium. Magnetic Island Resort, Magnetic Island, QLD.
 

Lakeman, R. (2005, 18-19 April). Reflections on the use of technology in clinical supervision: The medium and the message [Keynote]. Clinical Supervision Conference: Enhancing Practice, Shearwater Cape Schanck Resort, Mornington Peninsula, Vic

Clinical supervision has established a long pedigree in the helping professions as a tool to assist people hone their practice, sharpen their skills, and endure the traumas associated with working with people in distress. It has provided a means by which the otherwise private exchanges between health professionals and recipients of care can be reflected upon, examined and improved. The seeds for clinical supervision were planted and germinated in another age in which face to face therapy developed well beyond the gaze of the public, and the knowledge of health practitioners and therapists were inaccessible to all but a few initiates. In a little over a decade, as a consequence of the evolution in digital technology, the ground has shifted. In 1964 McLuhan coined the phrase “The medium is the message” and urged us to consider how we are shaped by the tools that we create. This paper reflects on the changes being wrought through evolving media on our notions of personal identity, community, helping professions and practices such as clinical supervision. If clinical supervision is to continue to bear fruit in the coming years then it will need to be a cultivar of the original variety, firmly rooted in concern for the intimate person-professional relationship but adapted to evolving media and shaped by the global context of professional practice.

Lakeman, R. (2003, 9 - 12 Sep). On-line clinical supervision for mental health professionals: No 8 wire to bridge the world and improve mental health practice. Paper presented at the Earth, Sky & No8 Wire: Australian and New Zealand College of Mental Health Nurses 29th International Conference, Rotorua Convention Centre, Rotorua, NZ.

Clinical supervision has a long pedigree in the mental health professions as a face-to-face relationship purported to assist in the maintenance of standards and to enhance practice through educative and restorative functions. The growth of the Internet and computer mediated communication technologies challenges the traditional notion that the context of clinical supervision need be face-to-face or undertaken by a supervisor intimately acquainted with the local practice setting. Over the last decade some psychiatric nurses and other health professionals have claimed that they have developed sustaining professional and collegial relationships akin to supervision or have actually entered into formal supervisory relationships using Internet technologies.

In 2002 an international research team comprised of a diverse range of disciplines collaborated in developing a long term research study to: explore the experience of computer mediated clinical supervision; establish the extent to which online clinical supervision matches the expectations of supervisees and meets professional standards; describe differences between computer mediated clinical supervision and face-to-face clinical supervision; and evaluate how communication practices are adapted using different computer applications in the process of online clinical supervision. This paper presents snapshots of the journey of this research team, and something of the reality and possibilities of on-line supervision.

Lakeman, R. (2003, 16-18 May). It was a good outcome but the patient is dead: A critical reflection on mandatory outcome measurement in mental health services. Paper presented at the North Queensland Sub-branch of the Australian and New Zealand College of Mental Health Nurses 5th Annual Tropical Symposium, Holiday Inn, Townsville, AU.

Before the end of 2003 Queensland Health will require ''outcome measures" to be undertaken for all patients of mental health services. This paper provides a critical reflection on the use of outcome measurements and selected aspects of Queensland Health's implementation. Using the metaphor of religion this paper will challenge some of the articles of faith that outcome measurement is founded upon and pose questions about the compatibility of these with other systems of belief which inform the recovery movement and which are fundamental to humanistic nursing care.

Lakeman, R. (2002, 18-20 Sep). Psychiatric nursing in a shrinking world: The impact and implications of the Internet and computer mediated communication on the field of psychiatric nursing practice, research and education (Plenary Paper). Paper preseted at the 8th International NPNR Conference, "Research Journeys: Travelling Together", St Cross Building, University of Oxford.   

Presentation on-line at: http://www.groupintervisual.net/hosting/npnr/

 Within the last decade computer mediated communication (CMC) facilitated by the growth of the Internet has transformed the way many people relate to each other and their world. In a metaphorical but very real way the world has become a smaller place in which distance and time may be transcended and bridges between cultures are built at a keystroke. The rapid growth in this area of technology and the exponential growth of internet usage poses a challenge to traditional notions of identity and community which are central constructs in the theorising and practice of psychiatry, psychotherapy and psychiatric nursing. This paper considers the impact and implications that CMC might have on the field of psychiatric nursing education, practice and research.

Lakeman, R. (2002, 18-19 May). Towards Assertive Community Care. Paper presented at the he North Queensland Sub-branch of the Australian and New Zealand College of Mental Health Nurses Winter Symposium, Rydges Capricorn International Resort, Yeppoon.

Lakeman, R. (2002, 18-19 May). I am not your broom: An examination of nursing's instrumental relationship to medicine. Paper presented at the he North Queensland Sub-branch of the Australian and New Zealand College of Mental Health Nurses Winter Symposium, Rydges Capricorn International Resort, Yeppoon.

Lakeman, R. (2001). The internet and nursing: Research and reflection (Presented by videoconference). Paper presented at the Network of Psychiatric Nursing Research (NPNR) 7th Annual Conference, Oxford, U.K.

Presentation on-line at: http://www.groupintervisual.net/hosting/assets/lists/psychiatric_nursing/npnr_show/index.htm

Lakeman, R. (2001, 21-22nd November). Getting our ACT together (Invited workshop presenter). Paper presented at 'Does Community Care Work?' An International Mental Health Conference, Wanganui Convention Centre, NZ.

Assertive Community Treatment (ACT) refers to a loosely related set of principles and practices focused on improving the lot of those identified as ‘heavy service users’, or those people who have historically been difficult to engage in treatment. A burgeoning body of research testifies to the effectiveness of ACT and a bewildering number of acronyms such as PACT, MIT,  MCT, TCL and MST have been coined to describe services more or less faithful to ACT principles. This paper describes the key principles of ACT, research on outcomes and ACT programmes, presents a sketch of the Mobile Intensive Treatment Team in Townsville and critiques ACT from an ethical perspective. It proposes that ACT ought to commence from a philosophy of community mental health firmly grounded in respect for people, and ought to be the primary business of community mental health services.

Nielsen, P., Lakeman, R., & Quadrell, M. (2001, 2 - 3 June). Promoting growth and development in a harsh climate. Paper presented at the The North Queensland Sub-branch of the Australian and New Zealand College of Mental Health Nurses Winter Symposium, Novotel, Palm Cove, Cairns.

A primary function of nursing has been described as the facilitation of the conditions necessary for growth and development. Some of these conditions are basic and common to all and helping agencies are charged with providing or assisting people to obtain them. This paper explores some of these conditions and how nursing is sometimes impeded from realising a truly helping function in North Queensland. Through the story of Phillip it will be illustrated how care that has the potential to be growth enhancing and proactive can become merely palliative and reactive in the face of rigid and inflexible bureaucratic processes. Phillip’s experience of being ‘helped’ and his often clear statements of need challenge policy makers and helping agencies to reappraise the meaning of ‘success’ in caring for people with enduring problems of mental health in the community. Our collective aims should be to assist people to thrive, not merely survive.

Lakeman, R. (2001, 2 - 3 June 2001). Welcome to the 22nd Century. Paper presented at the The North Queensland Sub-branch of the Australian and New Zealand College of Mental Health Nurses Winter Symposium, Novotel, Palm Cove, Cairns.

An exploration of some of the on-line resources available to the psychiatric nursing community.

Lakeman, R. (2000, 3-7 September). Coping with voices: An explanatory pilot study. Paper presented at the Mental Health Nurses for a Changing World: Not just Surviving,, Broadbeach, Queensland.

Hearing voices is an experience common to many people in psychiatric care but meaningful help in coping with the experience is less common. This paper presents a model of coping behaviour specific to hearing voices. It proposes that coping with voices includes hallucinatory control, emotion and problem focused coping and is a function of context, the features of voices, and beliefs about voices. Results from a pilot study exploring coping with voices are presented. A questionnaire which combined previously tested scales including voice topography (Hustig & Häfner, 1990), beliefs about voices (Chadwick & Birchwood, 1995a) and general coping behaviour (Carver, Weintraub & Sheier, 1989) was administered to 10 consumers of a mental health service with a recent history of hearing voices. The instruments were found to be reliable and easy to complete. Results are discussed in relation to the theoretical framework and suggest that people engage in a wide range of purposeful coping behaviour in response to voices that do not fit comfortably into arbitrary coping categories. Consideration of 'coping with' rather than 'amelioration' of voices ought to be a key focus of nursing, and the model of coping presented may be useful in making sense of, and facilitating coping behaviour.

Lakeman, R., & Monrad, G. (2000, 3-7 September). The lunatics have taken over the asylum: A conversation about mental health professionals and madness. Paper presented at the Mental Health Nurses for a Changing World: Not just Surviving,, Broadbeach, Queensland.

This presentation explores issues surrounding being a mental health professional with a mental illness. Whilst consumer groups are establishing a niche within psychiatric and mental health services, many professionals may rightly claim to "have a foot in both camps". This presentation aims to lay bare some of the attitudes, stereotypes and contradictions in belief which shape the reality of health professionals with mental illness. The presenter’s revisit the notion of the 'wounded healer' and suggest that the degree to which health professionals 'take care' of themselves and own their own vulnerability (collectively and individually) has a direct bearing on the kind of care that they can provide to others. The presenters have made similar presentations in the past and share some of the questions, which have arisen in their own practice and in response to previous presentations about the position of, and response to mental health professionals who have experienced mental illness.

Lakeman, R. (2000, 3-7 September). Nurses are more than tools: instrumentality and implications for nursing ethics. Paper presented at the Mental Health Nurses for a Changing World: Not just Surviving,, Broadbeach, Queensland.

This paper examines the ethical implications of nurses as tools, that is nurses carrying out the delegated or instrumental work of others. It is proposed that nursings' instrumental relationship with medicine, has in some instances led to an ethos, or moral climate which legitimises excluding nurses and patients from moral decision making and silences the moral voice of nursing. Nursings' involvement with compulsory psychiatric treatment is examined as a particularly problematic area of practice in terms of the legal requirement to carry out "doctor's orders" and exclusion from dialogue about the terms of treatment. Treating nurses as mere tools is challenged as unethical and the facilitation of a new health care ethos founded on values of collaboration, relationship and inclusion is proposed as a moral imperative for ethical health care.

Lakeman, R. (2000, 10 - 11 June 2001). Helping and hearing voices. Paper presented at the The North Queensland Sub-branch of the Australian and New Zealand College of Mental Health Nurses Winter Symposium, Arcadia Resort, Magnetic Island, AU.

This paper uses Slade's (1976) explanatory model as a framework for explaining hallucinations and considering helping interventions, which may be used alongside pharmacological interventions. Principles and practical ideas for how nurses might assist people to cope with and make sense of the experience are explored.

Lakeman, R. (2000, 10 - 11 June 2001). Welcome to the machine. Paper presented at the The North Queensland Sub-branch of the Australian and New Zealand College of Mental Health Nurses Winter Symposium, Arcadia Resort, Magnetic Island, AU.

                    Launching the sub-branch web site 

Lakeman, R., & Murray, P. (2000, 28 April - 3 May). The internet and its impact on nursing: Research and reflection on the benefits and pitfalls of computer-mediated communication. Paper presented at the One step beyond: The evolution of technology and nursing, Aotea Centre, Auckland, NZ.

The explosive growth of e-mail and other forms of Internet-based and computer-mediated communication (CMC) promises to have a dramatic impact on human relations, with implications for nurses and nursing as for any other section of society. If nursing is to benefit from changing communication modes, the experiences of nurses who have already adopted and adapted to using the evolving technologies must be explored. Both authors undertook research examining nurses’ use of the Internet in the mid 1990s, which provided a ‘snap shot’ and a baseline for examining future changes. This paper reports on the findings of research undertaken collaboratively in the late 1990s using surveys of psychiatric and general nursing e-mail list groups to explore changes which have taken place in nurses’ use of CMC. The responses, when compared with the earlier findings, reveal that a growing body of nurses have become more sophisticated in their use of CMC, and are producing resources on the Internet. More importantly, CMC is rapidly becoming an essential and integral part of the routine of many nurses and is resulting in changes in practice.

Monrad, G., & Lakeman, R. (1999, 29 Nov - 1 Dec). Caring for others requires caring for each other: Conversations about being a mental health professional with mental illness. Paper presented at the 'Realising Recovery' - Best Practice in mental health services., Plaza International, Wellington.

It is our belief, that the experience of emotional or psychological distress, or mental illness can lead to a much greater positive outcome than merely recovering what has been lost… It can lead to discovery… discovering something about what it means to be person.  Personal discovery we believe is an important component of recovery and being as well as being an effective helper

Lakeman, R. (1999, 2 - 3rd Feb). Charting the future today: psychiatric and mental health nurses on the internet. Paper presented at the New and Evolving Roles for Psychiatric / Mental Health Nurses, Eastern Institute of Technology, Taradale, New Zealand.

An examination of data from a study on computer mediated communication by psychiatric and mental health nurses

Lakeman, R. (1999, 2 - 3rd Feb). When the voices say more than 'thud'. Paper presented at the New and Evolving Roles for Psychiatric / Mental Health Nurses, Eastern Institute of Technology, Taradale, New Zealand.

                    A review of helping interventions for nursing the person who hears voices

Lakeman, R. (1998, 27 - 29 Nov). Bridging social and clinical conceptions of hearing voices. Paper presented at the Centres and Margins, Eastern Institute of Technology, Taradale, New Zealand.

One cannot begin to make sense of coping experience without an understanding of the person’s social world and how this informs and interacts with perceptions, and the attribution of personal meaning to the experience. The 1990s have been called the ‘decade of the brain’. Today a person’s experience can be manipulated in a myriad of ways through the use of pharmacological agents. Because it is possible to completely ameliorate voices does not mean that we should. More than ever we need to extend our understanding of the voice hearing experience and bridge social and clinical conceptions.

Lakeman, R. (1998, 24 Feb). A case for the amendment of the Mental Health Act and acknowledging the expertise of nurses. Paper presented at the ANZCMHN regional mini-conference and AGM, Staff Development Unit, Palmerston North Hospital, New Zealand.

Recently nurses around the country were called to contribute to a ministerial task force examining barriers which prevent registered nurses contributing to the realisation of a more responsive, innovative, effective, efficient, accessible and collaborative health service. This paper suggests that one need look no further than New Zealand mental health legislation and the medical hegemony over the compulsory assessment and treatment process to uncover barriers to nursing actualising it's potential.

Lakeman, R. (1997, 30 - 31st July). Using the internet for data collection in qualitative research. Paper presented at the Qualitative Research in Health and Disability, Eastern Institute of Technology, Taradale, New Zealand.

Lakeman, R. (1996). The internet: Facilitating and international nursing culture. (Conference Proceedings). (pp. 261-282). Auckland: ANZCMHN

The internet consists of some ten million computers networked together. It provides a means of human communication which transcends boundaries of language, race and sex, as well as providing people with access to an unimaginable quantity of information. This paper reports on a qualitative study undertaken to explore how psychiatric nurses experienced in the use of the internet currently use and benefit from it, how they have learned to communicate on the internet and how they see the internet affecting psychiatric nursing culture. 

Contents
Qualifications	Journal articles	Book reviews & commentary	Contributions to books	Conference presentations	On-line documents

Lakeman, R. (2002, 18-20 Sep). Psychiatric nursing in a shrinking world: The impact and implications of the Internet and computer mediated communication on the field of psychiatric nursing practice, research and education (Plenary Paper). Paper presented at the 8th International NPNR Conference, "Research Journeys: Travelling Together", St Cross Building, University of Oxford.   

Multi-media presentation on-line at: http://www.groupintervisual.net/hosting/npnr/

 Within the last decade computer mediated communication (CMC) facilitated by the growth of the Internet has transformed the way many people relate to each other and their world. In a metaphorical but very real way the world has become a smaller place in which distance and time may be transcended and bridges between cultures are built at a keystroke. The rapid growth in this area of technology and the exponential growth of internet usage poses a challenge to traditional notions of identity and community which are central constructs in the theorising and practice of psychiatry, psychotherapy and psychiatric nursing. This paper considers the impact and implications that CMC might have on the field of psychiatric nursing education, practice and research.

Lakeman, R. (2002, 18-19 May). Towards Assertive Community Care. Paper presented at the he North Queensland Sub-branch of the Australian and New Zealand College of Mental Health Nurses Winter Symposium, Rydges Capricorn International Resort, Yeppoon.

This paper described the principles and practices of assertive community treatment, research into efficacy, programme fidelity and outcomes. A description of the Mobile Intensive Treatment Team in Townsville was provided and case examples were used to illustrate the roles of the nurse in relation to people receiving care. Ethical aspects of assertive community treatment were discussed and a philosophy of assertive community care was proposed.

Lakeman, R. (2000, 3-7 September). Coping with voices: An explanatory pilot study. Paper presented at the Mental Health Nurses for a Changing World: Not just Surviving,, Broadbeach, Queensland.

Hearing voices is an experience common to many people in psychiatric care but meaningful help in coping with the experience is less common. This paper presents a model of coping behaviour specific to hearing voices. It proposes that coping with voices includes hallucinatory control, emotion and problem focused coping and is a function of context, the features of voices, and beliefs about voices. Results from a pilot study exploring coping with voices are presented. A questionnaire which combined previously tested scales including voice topography (Hustig & Häfner, 1990), beliefs about voices (Chadwick & Birchwood, 1995a) and general coping behaviour (Carver, Weintraub & Sheier, 1989) was administered to 10 consumers of a mental health service with a recent history of hearing voices. The instruments were found to be reliable and easy to complete. Results are discussed in relation to the theoretical framework and suggest that people engage in a wide range of purposeful coping behaviour in response to voices that do not fit comfortably into arbitrary coping categories. Consideration of 'coping with' rather than 'amelioration' of voices ought to be a key focus of nursing, and the model of coping presented may be useful in making sense of, and facilitating coping behaviour.

Psychiatric Nurses and the Internet

This paper presents the preliminary results of a research project undertaken using the internet and latter presented at the ANZCMHN International Conference held in Auckland, New Zealand in October 1996. A shortened article was also published in Computers in Nursing (Volume 16, Number 2, 1998, pp. 87-89) and a further article on using the internet for qualitative research was published by the same author (Computers in Nursing, Volume 15, Number 5, pp. 269-275). This online paper is the 'warts and all' results that were published to share with research participants to enable validation of the analysis.

Dangerousness and mental illness: The research and implications for nursing practice

This short paper was delivered at the Hawke's Bay Nurses Forum, and latter published in the Journal, Vision (Volume 3, Issue 4, 1997, pp. 10-13) Key Points: * Labeling a person as dangerous to others involves a prediction that the individual is likely to cause harm to another. * Research suggests that there is a relationship between mental illness and violence but is unclear whether it is a cause and effect relationship. * Epidemiological research informs about who has been violent but lacks precision in defining who is dangerous. * Biological, psychological, environmental and social-interactional factors may all contribute to violent behavior. * The strongest current predictors of violence at present are a history of violence, a history of substance abuse and a coercive interactional style. * Violence may be used in a purposeful way. It may be learned, reinforced and provoked through individual and group interaction.

What psychiatric nurses do differently: A discussion on the blurring of roles in the mental health professions

The notion that nurses working in mental health settings are loosing their identities as nurses and that institutional roles are blurring in the mental health field is not new. Nurses in New Zealand need to examine whether this is true for them in the context of the present health system. Relatively new roles are evolving in the community which require generic mental health skills and challenge previously held ideas about how nursing is practiced. Nursing is struggling to articulate what it has to offer which is unique to nursing. This paper examines some of the phenomena that may be contributing to the difficulties that nurses have in articulating and more importantly actualizing a distinctly nursing perspective in the field of mental health. The sources of nursings' identity from a historical point of view are examined first, leading onto a critical appraisal of some of the ideals espoused by nursing. The perceptions that nurses hold of what they do are examined and the implications for nursing education and research are discussed.

A Personal reflection on my experience as a mental health nurse in New Zealand

This paper is a (rather dated) personal reflection on the author's experiences working in the mental health area.