Psychiatric/Mental Health Nursing: Positioning Undergraduate Education

Abstract

The effectiveness of undergraduate comprehensive nursing programmes to prepare nurses to practice in the field of mental health is of concern to practitioners, educators and service providers. A crisis in the recruitment and retention of nurses to this field of practice is often linked to the marginalised position of psychiatric/mental health nursing within the comprehensive curriculum. In this paper the critique of the mental health component of comprehensive nursing education and the questions that it raises are explored from historical, structural and ideological perspectives. In order to locate the past and highlight its significance to where psychiatric/mental health nurses find themselves today some of the history of the asylum system and the development of psychiatric nursing in New Zealand within these structures are presented. Ideological changes to the way mental health was thought about and responded to have had considerable impact on where psychiatric nurses practiced, how they practised and what they were named. This created the need for a different kind of nurse and has led to changes in the education of nurses. The structural influences on the training and education of nurses are identified through relevant reports and their recommendations and significance in relation to psychiatric/mental health nursing are examined. Issues deriving from the critique of undergraduate psychiatric/mental health nursing education highlight the urgent nature of the crisis and draw out the multiple and competing discourses that inform the education of nurses. In acknowledging that the crisis can he viewed from multiple perspectives the need for responses from multiple levels involving the Nursing Council of New Zealand, the Ministry of Health, the Mental Health Commission and nurses in education and practice are recommended.