Book Reviews and Commentary

In this special article celebrating International Nurses Day, we hear from ACMHN Board Directors Donna Hansen-Vella and Richard Lakeman about mental health nurse (MHN) leadership: what it looks like, why Australia needs it, and how to empower MHNs to lead more.

Student evaluations, in the form of anonymous online surveys, are ubiquitous in Australian universities. Most students in most courses are offered the opportunity to rate the “quality” of their teachers and the course they take.

The original intention of student surveys was to help improve the learning experience. But it’s now become much more. Student surveys are often the only measure of teaching quality (along with pass rates). For lecturers, positive ratings and comments are often required to ensure continued employment or promotion.

But these anonymous surveys have also become a platform for defamatory, racist, misogynistic and homophobic comments against staff.

Despite good intentions, increased federal funding for mental health services is unlikely to have a great impact on mental health outcomes in Australia. Recently the National Mental Health and Suicide Prevention Plan was released with the announcement of $2.3 billion of extra funding, the largest single increase in mental health expenditure in the history of the Commonwealth and promoted as ‘transformative’.

However, at least half of the expenditure is devoted to extending existing programs, the clinical work of which is funded almost entirely via the Medical Benefits Schedule (MBS), and there is little evidence that this will enable people to receive the right treatment at the right time by the most qualified person, especially when that treatment is psychotherapy….

This was also reproduced at: Lakeman, R. (2021) Why a billion dollars won't buy Australia improved mental health, Health Times, 6th August, https://healthtimes.com.au/hub/mental-health/37/news/nc1/why-a-billion-dollars-wont-buy-australia-improved-mental-health/6074/

Australia’s higher education workforce has literally been decimated during the COVID-19 pandemic. Mass forced redundancies and non-renewal of casual contracts were highly stressful. And now some disciplines and academics who committed their lives to teaching feel publicly invalidated as unnecessary in the reconstruction of the sector to produce what the government deems to be “job-ready graduates”.

Our recent review finds academics in Australia and New Zealand were suffering high levels of occupational stress well before COVID-19. Recent upheavals only added to existing problems. This is likely to jeopardise recruitment and retention of staff even in the very areas, such as health, teaching and medicine, where the government expects high future demand…

The lack of recognition of the specialist skills of mental health nurses (MHNs) by the Australian Government in the Budget and the failure to address the mental health needs of the Australian population should be of great concern to nurses everywhere.

The truth is the mental health crisis from COVID-19 is only just beginning. We expect the impacts to be felt for some time into the future. The best thing we can do for the nation is to emphasize positive psychology to try addressing the challenges instead of forcing those seeking help into a narrowly focused, risk-obsessed biomedical funnel of care.

Australia is currently in lockdown, it’s State, and National borders closed, gatherings of more than two people in public are banned, and a raft of other unprecedented measures have been implemented in response to the COVID‐19 pandemic. This comes on the back of apocalyptic fires, floods and cyclones. Those that have been involved in recovery efforts in any of these events will have been witness to the resilience of the Australian community. These adventitious crises tend to bring communities together. This pandemic poses quite a different existential, psychological and social threat to Australians…

While the physical health challenges posed by COVID-19 are undoubtedly complex and for many tragic, the mental health repercussions will remain within our communities for years to come. Australia and Australian mental health nurses (MHNs) are regrettably well versed in responding to natural disasters. Devastating cyclones, bushfires, and droughts have all impacted our communities very recently. Mental health services often led by MHNs have responded to help communities and individuals adjust to the trauma and deep loss and to then go on and build resilience…

Since the advent of television, there has been concern about how “screen time” might affect the developing brains of children and contribute to health problems. Interacting with a device will inevitably change the brain and “how much” is “too much” is a question that preoccupies parents, educators and health professionals (Dickson et al., 2018; Gillespie, 2019). I invite health professionals to turn their gaze towards the provision of mental health care and consider how engagement with information systems may be impacting on their own development, view of mental health service provision and relationships with service users. I will focus on the Australian experience which may provide salutary lessons for other countries whose health services are not as far along the journey of becoming paperless and protocol‐driven.

There is an accelerating need for a skilled mental health workforce in Australia given the growing recognition of mental illness. However, developing an informed, flexible and skilled nursing workforce in hospital, community mental health and non-traditional settings is a challenge. The critical ingredients appear to be a mix of supported practice, particularly in the transition from graduate nurse to specialist, relevant postgraduate education and clinical supervision.

Since the loss of state registration and endorsement by nursing boards and councils, the only way to achieve recognition for mental health nurses is through the Australian College of Mental Health Nurses Credentialing program. To be eligible, registered nurses must have completed at least a postgraduate diploma in the specialty and met further practice and supervision requirements. Increasingly, these credentials are required for advancement for nurses in the mental health field – and rightly so. The public deserve to receive mental health nursing services from appropriately skilled people.

This editorial explores particular forms of epistemic injustice which mental health service users may be exposed to. Mental health service provision throws up some particular problems in relation to developing and sustaining just services. Like the problems which people bring with them to mental health care, justice is multifaceted and multidimensional. Whilst often it may seem that addressing injustice is too big a problem for any but the most heroic of individuals, much injustice is underpinned by testimonial injustice of various kinds which we as health professionals are implicated in perpetuating. Mental health professionals need to reflect on the way we engage with service users, consider their testimony and construct problems. To do so will have far reaching implications for creating just institutions and ultimately just societies.

Letter to the editor

Letter to the editor

Letter to the editor

A highlight for me of attending the First European Conference of Mental Health Nursing held in Helsinki in 2012 was a brief presentation by Neil Brimblecombe in which he discussed the similarities and differences in mental health services in Europe derived largely from the soon-to-be-released book 'Mental Health Services in Europe: Provision and Practice.' The facts and commenta ry were highly congruent with my own observationsthat I shared at this conference (see Lakeman, 2013), specifically, that, concealed behind a common language to describe services and readily available statistics, there are considerable differences in understandings and practices in Europe and elsewhere. Finally getting access to the text further confirmed this idea, but despite my familiarity with the topic, the book was nevertheless a “page turner” full of interesting surprises and observations…

Most people who are in the business of trying to help people deal with difficulties in their lives, their relationships and with negotiating health, welfare and justice systems do so with the best of intentions. However, as the proverb goes 'the road to hell is paved with good intentions'. The importance of this edited book by Phil Barker is the unrelenting subtext that the best of intentions are insufficient to be ethical in the helping professions….

Another beautiful book by Lorraine Nicholson also deals with the subject of depression but through the medium of poetry, art and imagery. This book will have pride of place in any collection for its aesthetic qualities alone….

This was an enjoyable book to read. It is somewhat medico-centric (not surprisingly as both authors trained as general practitioners) and more directly relevant to workers in Australia (with vignettes mostly relating to working with Aboriginal Australians or migrants to Australia) despite aspirations towards universalism. It is part guidebook and academic text but meanders into social commentary and observation. This makes it engaging to read even if it lapses into pop psychology or moralising in places….

Linda Morrison extends a sociological analysis to a complex social movement that appears (as the title of psychiatric consumer/ survivor/ex-patient suggests) to encompass some disparate positions in relation to psychiatry, psychiatric treatment, identity and activism….

Asylum was first launched in 1986 at 50p per issue but free to 'inmates'. Influenced by the antipsychiatry movement it captured and capitalized on the zeitgeist that was the evolving consumer/ survivor/ex-patient/activist movement and the promise of a revolution in mental health care….

This book claims to anticipate and answer all the questions readers may have about mental, emotional, or behavioural problems in young people that could be treated with medication. The potential market is the parents of the 7.5-14 million American kids (p.1) who the author claims suffer from psychiatric disorders. This is a big market which in part explains the reason for this book. Trust in psycho-pharmacological treatments and by association medicine has also been somewhat shaken in the US by the exposure of widespread off-label prescribing of psychiatric drugs to children in recent years and this text purports to offer a balanced, trustworthy source of information….

I am a fan of psychodynamic formulations in understanding individual and group behaviour. Almost all my students end up with a copy of Tom Main's, 'The Ailment’, a lecture on transference and hopefully some practical appreciation of how we affect and are affected by the people we work with. As a convert, with a little background training and reading I looked forward to opening this enticingly titled book. I did enjoy it (or parts of it) but remain somewhat ambivalent about whom I would recommend it to….

In this book race, ethnicity, culture and racism are central concerns. The first two chapters define the terms and outline their importance to mental health in a scholarly manner. These are definitely the strongest chapters, well argued and have some universal appeal. However, there is no mistaking that the book is written about the United Kingdom (UK), grounded in the UK policy context with examples really only making sense when considered in the UK context….

Dan Blazer, Professor of Psychiatry and Behavioural Sciences at Duke University considers why we appear to be in the throws of a pandemic. We are not in fact in an age of melancholy but rather in an age of major depression. One element of his thesis is that variations and gradations of the depressive experience have been conflated into the diagnostic label of major depression. Whereas once people may have been sad, blue, melancholic or attributed their distress to the vicissitudes of life now people have major depression….

This book edited by Australian academics and researchers, Robert King, Chris Lloyd and Tom Meehan is a thin volume of 224 pages divided into 15 chapters. It is promoted as a 'clinical handbook' for practitioners in the field of mental health and promises to appeal to a wide readership. Each chapter commences with an overview and some have reference to additional resources. Additionally a case study about a person called Sam is introduced mid-way through the text and elaborated on across some chapters….

'Alternatives beyond psychiatry' is mostly a book of stories. Before one reads a word the faces of most of the 61 story tellers greet the reader from the cover and for-tell a book steeped in personal and collective experience, insight and opinion. The book is edited by Peter Lehmann (who is also the publisher) and Peter Stastny, who have done a remarkable job in translating and weaving these stories into some kind of coherent whole. The overall focus is on the provision of care and support to people outside mainstream psychiatric services, or more particularly outside of bio-medical and coercive treatment paradigms. A vast terrain is covered….

NVivo is a software package to assist in the management and analysis of qualitative data. There are many such software packages now available (see: http://caqdas.soc.surrey.ac.uk/) and NVivo has a long pedigree being a descendent of NUD*IST by QSR. The latest release represents a substantial investment in terms of money, and computer resources (my near new laptop struggled to run the software). Qualitative analysis regardless of the tools available also takes a considerable amount of time so it is useful to get the most out of the software and not waste time needlessly….

This year marks the twentieth anniversary of the death of Carl Rogers and the commencement of my nursing training. It was during my training that I was first formally introduced to the philosophy and techniques of 'person centred' counselling. Indeed, for years I thought unconditional positive regard and counselling were synonymous. Our course was saturated with Roger’s philosophy and a number of my most inspiring teachers regarded Rogers with quasi-religious awe….

According to the blurb, this book is aimed at mental health professionals and promises to provide rich insights into mental health law in New Zealand. Given that nursing is by far the largest occupational group involved in the care and treatment of people with mental illness, my expectation was that this book would provide some welcome guidance and commentary on some vexing issues that confront nurses working with mental health legislation….