"We noticed early on that we could use our skills best if we put a mental health nurse at the forefront of the H2H clinic. That is quite different to some of the other H2H hubs," Sarah says. "We decided that Efraim, with 30 years of experience as a mental health nurse, should be the front of shop, doing the assessments."
When a client books an appointment with the H2H clinic, Efraim is the first person to see them and get a picture of their situation. "We then sit down with them and do a biopsychosocial assessment to find out what brought them in and how we can help. This is where your skills as a mental health nurse come in — to help you conceptualise the problem considering the physical, social, and psychological aspects of the presentation. We look at the person holistically, critically assess what we see and hear, and then form a base and a plan as well as an appropriate referral process," Efraim says.
Efraim highlights the unique skillset that mental health nurses bring to the table by describing a client facing long-standing anxiety and depression alongside complex medical conditions. "It's a narrative approach — it's a journey with a consumer, not just about the psychological condition but also the physical condition. We know that the psychological affects the physical and vice versa, and you gain insight pretty quickly if you have a strong base in mental health examination. As mental health nurses we see people at their most vulnerable and we get to bear witness to and advocate for that as we walk alongside those consumers to bring about the change that the consumer wants."
Sarah is keen to shine a light on what mental health nurses specifically bring to multidisciplinary teams. "At our H2H hub we're a multidisciplinary team and we all bring something different to the table. People can readily identify the role of the psychologist in the mental health arena, but we want to shine a light on the fact that there are other pathways for treatment of mental health conditions."
"It's a shame that mental health nurses don't have more opportunities. We're supported within the H2H model, but considering the limited number of MBS items we can use, we can't go out there independently and get paid. There is so much scope and opportunity for nurses to fill the skills void, particularly with our foundation in the medical model and with the current shortage of psychiatrists — financially it makes sense. Mental health nurses' skills in understanding diagnostic formulation and applying clinical judgement provides the right treatment and supports at the right time, particularly when we are seeing more and more complex client presentations. We're certainly being overlooked in that regard."