A total of responses were received from both countries, comprising The Australian participants represented three states of Australia while respondents in the UK sample were located in the North and North-West of England.
Participants were asked to provide demographic information relating to age, gender, ethnicity, locality distance of home from place of study and level of prior education. Some demographic differences between the Australian and UK samples were observed. The proportion of participants stating their ethnicity as white was higher amongst Australian participants than British participants who had a higher proportion of participants stating their ethnicity as African.
Other ethnicities were approximately equally represented in both countries. The mean age of participants in both countries was similar see Table 1. All UK respondents were enrolled in a diploma or nursing degree with a specialty in Mental Health. The majority of the Australian respondents were enrolled in a comprehensive nursing degree in which University mental health education had been only delivered as a stand-alone subject s within the whole degree , and a small number were also enrolled in a midwifery degree.
MHN teaching in the degree program was indicated as being predominately a standalone subject A third of respondents indicated they were unsure whether they would choose MHN as a career and a third indicated they would not choose MHN at all The comprehensive program represented by the Australian sample revealed a third of respondents indicated MHN was definitely not a career option for them. This finding is similar to other studies in terms of the poor popularity of MHN as a career choice for nurse graduates of the comprehensive degree [ 2 ].
However, encouragingly a similar number of the Australian sample indicated they would either consider MHN as a choice of career or remained undecided.
This is a more positive outcome than seen in other studies [ 2 , 5 ]. When considering the Australian cohort who were enrolled in a comprehensive degree, the results of our study are similar to one undertaken with medical students [ 7 ].
In a study undertaken by Halder et al. The study revealed there was little difference noted in the student ratings of lectures between those who chose psychiatry and those who did not. This finding is also similar for nursing students [ 5 ]. Mental health service delivery is often experienced as a different speciality to others in health due to issues such as stigma and uncertainty related to the professionals role [ 5 , 9 ].
This altruistic desire appeared to emerge after exposure to the area of psychiatry when they are in their under graduate degree and can be expressed later as a career choice [ 9 ]. A desire to make a difference was also evident in other health disciplines such as allied health where altruistic motivations dominate career choice [ 10 ].
It is in this context that helping another may offer benefits for both the helper and the recipient [ 11 , 12 ]. Immersion in mental health settings for students to develop or discover pro-social behaviours behaviour intended to benefit another may manifest into a possible desire to make a difference to people who live with mental illness.
Enhancement of motivation for opting for MHN as a career option as revealed in the findings of this study suggests greater exposure or experience of mental illness through such activities as career immersion, mentorship, preceptorship or personal experience. Structured career immersion in mental health education, with an emphasis on the important role of mentors, may offer positive returns for nursing [ 13 ]. Career immersion has been used in some nursing settings to prepare students.
For example a brief immersion practicum at a mental health facility where students were assigned to one specific setting for six consecutive weekdays 45 h , without the distraction of other classes, was undertaken due to declining clinical rotation availabilities. Students thought that their ability to form therapeutic relationships with consumers and integrate theory into clinical practice was enhanced through this immersion experience [ 14 ]. It has been suggested that such immersion may take various formats such as simulation experience as a person who is living with serious mental illness [ 15 ], simulated case scenarios using high fidelity simulations for mental health education [ 16 ] or 40 h per week for a full semester after completing theoretical content [ 17 ].
The limitations of the study relate to a purposive sample as compared to random selection. Potentially this could affect the generalisability of the findings if the sample was systematically different from the parent population; however, no evidence for selection bias or response bias was apparent.
In light of these limitations generalisations are prohibitive, nevertheless findings do highlight areas for further exploration, particularly ways to increase exposure of mental health education in comprehensive nursing curriculums. Career immersion, as undertaken in the specialty program, may offer a means whereby students enrolled in a comprehensive nursing degree have greater exposure to mental illness and thus an opportunity to develop or discover pro-social behaviours such as a desire to make a difference to someone experiencing mental illness.
Career immersions have been seen to work in both medical and nursing curriculums in recent times and may be developed in curriculums using a variety of techniques such as simulation and block placements without the distraction of lectures.
While it could be assumed that students enrolled in a specialised MHN program are potentially more motivated towards that specialisation than a comprehensively educated nurse the knowledge of student motivations in terms of making those career choices has remained unclear.
Further examination of career immersion in mental health nursing and its impact on career choice however is warranted. Graduate-only pre-registration mental health nursing programmes. Nurs Stand. Article PubMed Google Scholar. Career in mental health still an unlikely career choice for nursing graduates: a replicated longitudinal study.
Int J Ment Health Nurs. Final report. Stuhlmiller C. Rethinking mental health nursing education in Australia: a case for direct entry. Happell B, Gaskin CJ. The attitudes of undergraduate nursing students towards mental health nursing: a systematic review. J Clin Nurs. Interviews for mental health nursing students: key considerations for the panel.
Mental Health Nursing Online. Google Scholar. SPSS I. A discussion of this study's most important findings by theme follows. Theme 1: Community-learning engagement.
The students experienced the community-learning engagement as a different, enjoyable learning experience, and as a learning environment conducive to integrating theory and practice.
Through their intrapersonal reflection on action they indicated it as a 'Positive way of learning' P26 and that they 'enjoyed the time I have spent' P In the process, they were stimulated to think critically and they described service learning as thought provoking. Service learning helps students to foster higher levels of thinking, builds problem-solving skills and enhances the application of learning to real-world settings.
The students described outreach community-learning engagement as follows:. Furthermore, intrapersonal reflection on action provided by students assisted the nurse educator to assess the preparation of nurses for their roles in the clinical setting. A student reported that:. I was able to measure the little knowledge I have about first interview assessment, diagnosis and intervention.
Structuring the curriculum to provide learning experiences that prepare students to meet the healthcare needs of communities is the work of academic faculties.
Students acknowledged that community engagement was an important assignment for students to learn. Students valued hands-on learning:. Outreach to a community-learning environment exposed students to different learning experiences that relate to all the facets of their training. Theme 2: Needs of the community.
Students experienced that valuable mental health services are rendered in the community: 'Outreach was about empowering patients, parents, and professionals with necessary skills to manage mental ill-health and parenting through workshops' P2 that could empower the people to take responsibility for their own mental healthcare.
Through their encounters, students developed a better understanding of and empathy for the needs of children and the community. Face-to-face learning experiences enhanced the nursing students' sense of connection with the community, which fostered a sense of belonging. But, I learned that one could do as much as resources will allow, and I had to learn to appreciate and be thankful for the little that I had done for those families in the short time I had with them.
Students developed an appreciation of the nature of the community by being involved in the outreach programme. I have learned that when you engage families in the care of their child, they feel like partners and we get a positive result. The students experienced different cultural values [19] and learnt to respect the wishes of community members and how the students could make a difference:. I did manage to give them parental guidance.
In one family two or three are mentally ill or the child is abused or raped. I asked myself what 'is1 wrong with this community. They recognise that not all situations could be treated in the same way: 'Particular intervention or initiative might not apply for every community' P2. The students identified community needs and experienced ethical dilemmas:. It was not always easy for the students, as they experienced some challenges:.
We had good welcoming smiles. However, they experienced it as worthwhile to endure:. The students learnt to act on the challenges and needs of the community, which stimulated them to do more for a better outcome for the user of the mental health service. Theme 3: Professional development. Working in a team with other healthcare providers helped students to deliver better care to the people. One shared that it was a 'Good learning place for students and the team members are always ready to guide the students'.
P4 Students need to participate as members of an interdisciplinary team and to collaborate with members of a selected community to identify mental health-related issues and concerns. The experiences of others during community engagement - specifically hearing from their peers how the children responded - and the types of questions their peers asked, helped students to develop professionally. Overall, learning effectiveness is improved when individuals are highly skilled in engaging, collecting, interpreting and utilising data from multiple sources to assist in improving the health of a community.
Moreover, reflection reports helped them to do intra- and interpersonal reflection actively. Self-awareness helped the students to grow professionally and personally. Furthermore, the 'Opportunity to work independently' P11 helped students to become more confident:.
The experience made students aware of their strengths and weaknesses:. Several students valued the opportunity to learn and practise in a reciprocal knowledge-sharing environment, to identify gaps in their knowledge and skills. One student reported:.
It seems that the community engagement helped students to become autonomous. One shared that:. Community engagement also prepared the students, as one mentioned:. Osman and Peterson [21] believe that students, through their experience, construct their own understanding of the world around them, and then they will learn. Service learning provides a rich context for students to learn through real-life experiences, and to develop academically, socially and as civic participants in a democracy.
Critical thinking is stimulated in various ways during this community-engagement experience. Theme 4: Practising responsible citizenship. Even though students developed professionally, they were required to make responsible decisions beyond their scope of practice and, thus, the experience touched on their social responsibilities as citizens of SA. In the communities, students were confronted with challenging issues, such as ethical dilemmas, inadequate human resources and financial and logistical problems.
One student wrote:. Another student expressed that they needed to empower the community:. These realisations helped the students to develop their activist scholarship, and to deliver service to the people. Most students reported finding the hands-on education that service learning provides valuable:.
One student summarised the experience:. It is to make healthcare services equally accessible to all SA citizens irrespective of colour, economic status and whether it is in rural areas or townships. From these responses it is evident that nursing students are serious about their development as advanced child psychiatric nurses, and that they will advocate for their patients' rights and become involved citizens.
The results indicate that students experienced how important community-service learning is. Students could link theory to practice, apply learning in a specific community context and address specific needs of the community in a holistic manner.
Nurse educators can increase the students' effectiveness by including service-learning concepts and actual field experience in academic education. Through experiential learning education, students discovered relationships among ideas, rather than passively receiving information.
The students engaged in critical thought and discussion about the construction of knowledge. Nursing students learnt about all the important components of child mental health, and they could identify what Bronfenbrenner's ecological systems theory [24] means by the explanation that a child is exposed to and influenced by many systems. Because children are part of families, communities and society, they cannot be treated in isolation. The students worked in the midst of all these systems.
They experienced the needs of the community and, more specifically, the family. During their outreach sessions, nursing students could compare their performance and learn from one another, as well as from professional team members, e.
A good working relationship among members of the multidisciplinary team and provision of support on personal and professional levels are important for improving the professional development of students. Based on the students' comments, they learnt the value of intercultural communication, advanced therapeutic relationships cross-culturally, improved their language skills and collaborated with community liaisons. Learning is best conceived as a process, not in terms of outcomes. For example, most PMHNs tend to explore environmental factors that influence mental health and help people develop stronger interpersonal relationships, rather than providing treatment using medication or psychotherapy.
As nurses, PMHNs work alongside healthcare workers with more advanced education, such as psychologists and psychiatrists, to offer support. A PMHN is typically not qualified to perform more complex or involved elements of care, such as making formal diagnoses, coming up with advanced treatment plans, and prescribing medications. In this capacity, they can offer services that psychiatrists and psychologists do, such as prescribing medications, making formal diagnoses, and running their own practice.
Alternatively, a person may search directly for a local psychologist or a local psychiatrist. People seeking the care of a psychiatric nurse should talk with their doctor, who can refer them to an appropriate specialist.
Someone may also receive care from a PMHN if they are under the care of other mental health professionals. People who are experiencing negative side effects from mental health or behavioral conditions should seek help from a licensed mental healthcare professional. A person should also seek help if they or their loved ones have potential warning signs of mental health conditions.
These include:. People with health insurance should contact their insurance provider to identify clinics in their local area that their plan covers. How much someone pays to see a PMHN typically depends on the type of insurance and copayment they have for mental healthcare services.
A copayment is an amount a person pays out of pocket for healthcare services that insurance covers. The amount depends on the particular service. Referral services, such as those that SAMHSA offer, can give people who have low-coverage insurance or no insurance access to state-funded programs. These may offer free or reduced-cost services. People can also ask their healthcare provider to refer them to facilities or clinicians that offer their clients a sliding-fee scale or accept Medicaid or Medicare.
Psychiatric mental health nurses PMHNs are registered nurses with specialized training that help assess, address, and monitor mental health and behavioral conditions.
A person should seek help or guidance from a mental healthcare professional if they or a loved one experiences unexplained or concerning symptoms.
These can be any symptoms that negatively, rapidly, or dramatically affect elements of mood, behavior, thinking, or actions. A psychiatrist is a medical doctor who may use psychotherapy alongside prescription medication to treat people with mental health conditions.
Psychotherapy can help people with various psychological conditions, including stress, phobias, and bipolar disorder.
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