Teaching & Learning Resources

Mental health nursing is one of the oldest regulated health professions in the world. It predates the invention of all other allied health professions. At the core of it's history and practice is psychotherapy. Psychotherapy is a transdiciplinary activity. In my country of residence of Australia, neither psychotherapy, nor mental health nursing are treated respectfully.

Psychotherapy is often conflated with psychology and mental health nurses are viewed as having few skills in either. Psychotherapy is the treatment for most problems of living and has been for most of the 20th century. This page celebrates and promotes psychotherapy as sometimes the only effective treatment for mental health problems, and also mental health nursing as a specialty which is often excluded from practicing this craft in Australia, despite often being experts in the field.

Credentialed Mental Health Nurses (MHNs) in Australia are highly skilled, and educated Mental Health Professionals. All have postgraduate qualifications and many are experts in the provision of psychotherapy including working with those with the most complex health issues (see: 1, 2, 3). Successive Governments have failed to recognise the expertise or potential of MHNs. What was formerly known as the Mental Health Nurse Incentive Programme (MHNIP) offered some of the most vulnerable in the community access to medium to long term psychotherapy (see: 4,5) despite this not being officially recognised (see: 6). The MHNIP was handed to the Primary Health Care Networks (PHNs) as part of their flexible funding pool and any reference to the therapeutic capability of MHNs removed from the guidance notes on 'Stepped Care' (see: 7). Some PHNs have prevented MHNs from continuing to provide care to those in need. MHNs have been locked out of providing care under the Medicare Benefit Scheme including COVID-19 funding for tele-health measures (see: 8, 9). MHNs should have full access to the MBS, and their therapeutic skills recognised by all funders of mental health services.

This site is a repository for a variety of resources relating to a study undertaken between 2009 and 2010 exploring how homeless sector workers deal with and respond to death and trauma of people with whom they work. The site hosts a video of homeless sector workers talking about their experience, handouts and articles relating to the study.

Richard Lakeman was a founding member of this organisation and developed the web site.

I and a group of colleagues, John McCarthy, Harry Gijbels and Pat Bracken attempted to have a section of the Irish Mental Health Act repealed. Specifically section 59b which allowed for ECT to be administered against someones expressed wishes:
(b) where the patient is unable or unwilling to give such consent—
(i) the programme of therapy is approved (in a form specified by the Commission) by the consultant psychiatrist responsible for the care and treatment of the patient, and
(ii) the programme of therapy is also authorised (in a form specified by the Commission) by another consultant psychiatrist following referral of the matter to him or her by the first-mentioned psychiatrist.

The on-line petition which was completed by over 1500 people was hosted at www.delete.com We were successful in as much as the word 'unwilling' was dropped from the legislation.

Almost every nurse I have spoken to who worked in a psychiatric hospital kept their keys on finishing their employment (perhaps not so easy in this age of swipe cards). The keys are a powerful symbol for service users and nurses. I collected this selection from various colleagues. Consider recommending the web site or using the montage on a powerpoint slide to stimulate discussion. This was quite a contentious project when I embarked on it with some people finding the whole idea offensive. Certainly, the custodial function of the nurse or key carrier is an emotive one.

This is a small repository of resources relating to voice hearing including articles, handouts and web links.

This on-line program was developed by Richard lakeman and Wayne Froggatt to assist people in identifying and changing patterns of thinking which may cause distress, or problems of living. It is based on principles of cognitive behavioural therapy, which hold that much of our distress may be traced to patterns of thinking, interpretation and appraisal. A growing body of research suggests that much emotional distress and unsatisfactory patterns of responding to events may be brought under our control by developing insight into our patterns of thinking.

This is a page I wrote many years ago in javascript which has sets of questions on metric conversions, calculating tablet and fluid dosages, and IV drip rates. The questions were generated by the software package 'Drug Calculations for Health Professionals'

• The Medicare Benefit Scheme (MBS), ‘Better Access’ program which focuses on providing subsidized focused psychological strategies is out of reach for large sections of the population due to the overvaluing of this service by eligible providers who charge excessive ‘gap fees’. Mental health nurses (whilst eligible through PHN funded programmes to provide services for people with higher level needs or when people can’t afford ‘gap fees’) have been excluded from the MBS. Additionally, eligibility to provide ‘Better Access’ has become the de-facto benchmark to provide other MBS items (e.g. the recent eating disorder Item Numbers) and a criteria for employment in many services such as headspace.
• Mental health nursing is one of the oldest regulated professions, most trusted, and with a strong history and tradition of providing psychotherapy to those with the most complex needs. Surveys of mental health nurse psychotherapists in Australia indicate that they are highly trained (generally with Masters level qualifications specifically in psychotherapy) and often have decades of experience providing psychotherapy to vulnerable groups.
• The public have been unfairly excluded from being able to access a subsidized service from Mental Health Nurses who may be the most experienced and able providers; MHNs have been unfairly discriminated against in primary care by being unable to earn a living providing skilled services in competition with often less skilled yet subsidised practitioners.
• Granting immediate eligibility to MHNs to claim the MBS will address a serious skills shortage in primary care across the continuum of stepped care without the need for any further investment in training or education of health professionals.

In May 2013 the American Psychiatric Association plans to launch the Diagnostic and Statistical Manual version 5. This is apparently the most anticipated event in the mental health field and is accompanied by hype more often associated with the release of a new iphone (and the similarity doesn't end there). This presentation will explore the scientism associated and perpetuated by these diagnostic manuals, the notion that faith, rather than science underpins many of the assertions made by spokespeople (often with conflicted interests) in the mental health industry and it will consider the impact of these manuals on mental health practice culture.

This is an hour long vodcast of a lecture relating to the meaning of mental health. It considers how we have come to view mental health problems as discrete from other problems, how mental disorder is categorised and what the implications of our changing conceptions of health and illness are in relation to stigma and discrimination. The PDF link is to associated readings and references.

A 16 minute high definition streaming video in which homeless sector workers discuss their experiences dealing with the deaths of homeless people.

Calculate Body Mass Index (BMI) using either standard / imperial or metric measures of height and weight, or a combination of both. See the BMI plotted on a standard chart. This software is written for windows mobile devices.

This software was developed as a solution to the highly complex task of maintaining records of professional development and educational activities for the purposes of applying for and maintaining credentials for practice. I wrote it for the ANZCMHN but it was never formally endorsed so I shelved the software which is a shame because it worked very well. It enables all manner of activities to be logged and continuing education and practice credits automatically calculated. An application and renewal can be automatically generated and sent via e-mail. This package also has wider applications as a curriculum vitae can be generated and/or it may be used to demonstrate to other regulatory bodies evidence of training and education.

I wrote Easy Test Creator (ETC) to assist in the creation, administration and analysis of computerised and on-line tests, surveys or questionnaires. In the community mental health team I worked in we often employed various questionnaires and tests. This helped save time with entry, scoring and tracking change over time. ETC is particularly useful for researchers, clinicians, or those who simply wish to add a more sophisticated questionnaire to their web page. Some people may use this software to collate routine outcome data in clinical practice.

I placed the following scales on-line:
Abnormal Involuntary Movement Scale (AIMS)
Alcohol Use Disorders Identification Test (AUDIT)
Beliefs About Voices Questionnaire (BAVQ) - Amended
Brief Psychiatric Rating Scale (BPRS)
CES-D Major Depressive Disorder Scale
Edinburgh postnatal major depressive disorder scale (EPDS)
Geriatric Depression Scale (GDS) - Short Version
Health of the Nation Outcomes Scales (HoNOS)
Life Skills Profile (LSP)
Self-defeating Beliefs Questionnaire

In 1997 I wrote a computer programme called drug calculations for nurses. The programme was extensively revised in 2005 and remarketed as 'Drug Calculations for Health Professionals'. Over 500,000 people have downloaded the software from my site: www.testandcalc.com. It is shareware which means there is only a moral requirement to pay to register it if it is found useful. Approximately 50 schools of nursing or staff development units have registered the product.

An exercise to help with unwanted, or intrusive thoughts, ruminations or compulsions.

'Working with people to improve their health, welfare and wellbeing can be exceptionally rewarding. These rewards can be even greater when working with vulnerable people or those who for complex reasons have not been reached or helped by mainstream services. One can make a great difference to those who find themselves homeless or disconnected from other natural and health sustaining supports. Our hopes and dreams for people's recovery, or to improve their situation are often realized and this is wonderful. However, sometimes they are not, and few events wound and damage our professional esteem than the death of a service user whom we hoped to help and could not. Such events, and more particularly, the ways they can wound and adversely effect the worker are rarely discussed. This project stemmed from a personal interest in how people deal with traumatizing aspects of work.. I undertook a study exploring the processes involved in dealing with the death of service users, and this package of resources (video, slides and discussion documents) is a way of sharing some of the findings. I hope that the direct quotes of people from the homeless sector and the questions posed in this document will stimulate discussion, assist in service improvement and help people cope with the death of service users so they can maintain hope, move on and continue to provide a necessary and good service to people without being harmed in the process.'

This resource is a product of a collaboration between Dr Richard Lakeman and Dr Evelyn Gordon of Dublin City University and numerous people who work in the homeless sector in Ireland including the initial research participants (quoted throughout, but whose identities remain anonymous), their employers, and advisory group who generously gifted their time (Ciaran Maquire, Erin Nugent, Jimmy Goulding, Grainne Lynch, Barbara Corcoran, Niamh Cullen, Susie O'Keeffe, Anthony Bagnall and Stephen Doyle). This project has been supported by the Homeless Agency and a grant from ESB ElectricAid Ireland.

I use this to encourage discussion around mediating factors that affect stressful life events. Most people agree that it isn't simply the accumulation of life events that might predispose someone to ill-health, rather issues such as appraisal of meaning, how an experience is shared, choice and control etc will have an impact. So the really interesting part of using this questionnaire is the critique of it.

Holmes, T.H. & Rahe, R.H. (1967). The social readjustment rating scale. Journal of Psychosomatic Research, 11, 213-218

This handout encourages students/helpers to reflect on the kind of help and support they would like if they needed to use the helping service and importantly the kind of qualities they need to develop as effective helpers.

This is a handout to encourage people to focus reflection on a point or issue that is unclear to them. I have used this largely with undergraduate students on placement in mental health settings and a variation for considering course content.

One of the most perplexing interpersonal situations a mental health professional will encounter is how to respond to another's expression of bizarre or frankly delusional ideas. The adage 'Don’t argue but don’t reinforce' fixed false beliefs leaves one decidedly short on solutions. Using tricks such as diversion, switching topics or worst of all, ignoring the expression runs the risk of invalidating the person’s experience and leaving them feeling misunderstood or unheard. Whilst, these tricks may not reinforce the delusion they may reinforce a sense of alienation. This brief paper provides some principles on how to respond in a therapeutic manner to someone who expresses bizarre or delusional ideas.

I have never been overly fond of the 'nursing process' but concede that learning and practicing this linear problem solving process can be particularly helpful for students. If they are required to complete these care plans as part of their roles then they might as well construct them logically.

This is a handout that I sometimes give out during 'hearing voices' workshops. It provides some practical 'evidence based' guidance on some things that may help people control aspects of the voice hearing experience or give some relief to particularly intrusive voices. The sense that people can exert some control over the voice hearing experience is exceptionally important.

This is a handout to encourage students / helpers to reflect on their interpersonal communication with a preceptor with a view to increasing their self-awareness.

A one page handout outlining the 'Health Belief Model', some points about motivation and the 'Stages of Change'.

A few pages on mental status assessment. It may be helpful as a glossary of terms used in psychiatric settings.

A very old resource created when I was interested in herbal medicine

Academics may experience a loss of enjoyment, depression and panic attacks when the cycle of teaching evaluations occur, mental health researchers have found. An interview with Associate Professor Richard Lakeman

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.