Overview

1. Te Ao MaramatangaNew Zealand College of Mental Health Nurses Inc Partnership, Voice, Excellence in Mental Health Nursing www.nzcmhn.org.nz

2. Overview • MHN vision • TAM history and structure • TAM strategic plan, current projects, influence on policy, professional practice and education • TAM - member opportunities • MHN – expanding scope of practice, why • MH Nursing – physical health and A & D issues • MH Nursing influence on addictions work

4. Mental Health Nursing – the vision Maximising the potential of mental health nursing • Working with the whole person, whanau and communities • Working across sectors • A well articulated MHN voice and role within the health sector • Politically active with the ability to influence

5. Members make the college

6. History • Psychiatric nurses’ meeting, Porirua, 1987 • “Te Ao Maramatanga” • NZ became a Branch of ANZCMHN in 1994 • Development of separate College began in 2002 • College logo developed from 2003 Conference • Te Ao Maramatanga launched in 2004 • Professional leadership in mental health nursing • Confirmed existing Standards of Practice

7. Tony O Brien

8. The President

9. Maori Caucus • Maori nurses • Uniquely NZ – College structure reflects who we are as a country, working in partnership to achieve college objectives and strategic goals

10. Hineroa(Kaiwhakahaere)Heather & Tony

11. Strategic Goals • Advocacy – to provide professional leadership for members, and public advocacy on MH issues • Communications – to communicate effectively and efficiently to college members, MH stakeholders, and the public • Membership – to continually attract new members and to maintain a diverse and representative membership base • Strategic Relationships – to develop and maintain relationships with key stakeholders nationally and internationally • Professional development – to advance the educational, clinical and political expertise of members

13. Focal points • Infrastructure development • Professional Issues • Recruitment and Retention of MH nurses within the MH sector • Professional Involvement and Identity Mobilising the ‘power within’ Mobilising the ‘power internationally’

14. Boards • Education - Carmel Haggerty • Professional Practice - Kaye Carncross • Research - Brian McKenna • Scholarships – Rita McKewen, Frances Hughes Policy, Research

15. Australia & New Zealand

16. Member opportunities • Representation in policy process • Representation in regulatory processes • Contribution to national MH nursing voice - Submissions • Development of position statements • Regular newsletter • Website • Conferences and Wananga • Project work • Networking nationally, practice networks • Access to International Journal of Mental Health Nursing

17. Conference Theme Expanding scope of practice in Addictions – policy, professional practice and education

18. Why is this important? • 40% of people who met criteria for substance use disorder also met criteria for an anxiety disorder and 29% met criteria for a mood disorder (Te Rau Hinengaro) • 74% had concurrent disorder – 65% anxiety, 53% mood (Adamson et al. 2006)

19. Receiving methadone treatment • 33% taking medication for a MH problem • 33% taking medication for physical health problem (Deering et al, 2004) • Lack of health consultation about +ve hepatitis status (Deering, 2007; Sheerin et al. 2004) • High rates of reported health concerns with low rates of actual health consultations (Sheridan et al. 2005)

20. Therefore People who enter Addictions services • Complex array of substance abuse disorders and • Coexisting MH, physical health and social issues which impact on their day to day functioning and limit participation in family, whanau and community life

21. Registered Nurses • Focus on individuals, families and communities responses to health and illness in the context of daily life • Have generic RN competencies • Specialise into MH and addictions • Maintain generalist knowledge, develop specialist knowledge and skills – apply both to meet needs in a holistic way

22. Case example - liaison • 40 year old died of cervical cancer, never had a smear test, detected via symptoms, palliative care only – mental health stable at time of death (depression with history of heavy alcohol use) • Isolative – most significant relationship was with MH team – no evidence of physical health considerations as part of treatment plan • Good treatment for MH issues - we kept the patient alive by assessing and managing risks of suicide but patient died anyway – this death was preventable!

23. Physical Health • Physical health needs of people with SMI well established • Nurses practising in MH have a growing awareness of their need to consider physical health issues – screening, health promotion, health education, recording baseline and detecting changes, referring on when appropriate

24. Generic RN competencies with MH and Addictions specialty knowledge and skills • As RNs we have a broad scope - seize this opportunity, expanding the MHN scope of practice to meet the health needs of the people we work with • MH speciality, alcohol and drug additional knowledge and/or qualifications on generalist base knowledge

25. MH Nurses working with A & D issues • Yes we can! • Yes we need to if A & D issues are an issue for the client • What can we do • Assessment and brief interventions • Health promotion/education • Enhance motivation for behaviour and lifestyle change • Consultation and shared care approaches • Active linking and referral • Instil hope and be patient and realistic – change takes time

26. MH Nursing influence on addictions work • Working with the whole person – mental disorder, mental health issues, addictions, physical health issues • Comprehensive assessment, health promotion, health education, strong generic health understanding, systemic ways of working, well developed psychosocial skills, talking therapies, coaching, motivating, partnership approach • Clinical intervention, detox/withdrawal, overdose, intoxication, motivational interviewing, client education for harm reduction

27. MH Nursing influence on addictions work • Understanding pharmacology and pharmacokinetics of commonly used medications in A & D • Referral to appropriate agencies, based on clinical assessment and treatment outcomes • Co morbidities and impact on physical and A & D treatment • Legislative and ethical dilemmas

28. Maximizing the potential • Of MH Nursing - expanding scope of practice to meet needs of people using MH Services - physical health and alcohol and drug issues • Through mobilising the power within our profession to influence policy, professional practice and education - College membership and contribution