Working in the real world: a review of sociological concepts of health and well-being and their relation to modern mental health nursing

Preparing master-level mental health nurses to work within a wellness paradigm: Findings from the eMenthe project

Mental health promotion remains an important component of mental health nursing practice. Supporting wellness at both the individual and societal levels has been identified as one of the key tenets of mental health promotion. However, the prevailing biomedical paradigm of mental health education and practice has meant that many nurses have not been equipped to incorporate a wellness perspective into their mental health practice. In the present study, we report on an exploratory study which details the knowledge, skills, and attitudes required by master-level mental health nurses to practice within a wellness paradigm from the perspective of three groups of key stakeholders: (i) service users and family members (n = 23); (ii) experienced mental health nurses (n = 49); and (iii) master-level mental health nursing students (n = 37). The findings, which were reported from individual and focus group interviews across five European countries, suggested a need to reorientate mental health nursing education to include a focus on wellness and resilience to equip mental health nurses with the skills to work within a strengths-based, rather than a deficits-based, model of mental health practice. Key challenges to working within a wellness paradigm were identified as the prevailing dominance of the biomedical model of cause and treatment of mental health problems, which focusses on symptoms, rather than the holistic functioning of the individual, and positions the person as passive in the nurse-service user relationship.

Exploring the compatibility of mental health nursing, recovery-focused practice and the welfare state

Mental health nurses are expected to adhere to a range of professional values. The values of social integration that mental health nurses practise are somewhat at odds with the values of the British welfare state. Alternative systems of welfare support are demonstrated in other countries. Mental health nurses must consider models of practice, such as that described by Clifton et al. (2013b), to manage the disconnection between what is expected and what can be achieved. This discussion paper considers the implications for mental health nursing practice when working alongside individuals in receipt of state benefits. There is arguably a profound impact on an individual's recovery from mental ill health when that individual is also dependent on financial support from the government. Access to welfare benefits can have a significant impact on the recovery journey of that individual. This discussion paper will consider the practice implications for mental health nurses whose professional values include maxims such as 'challenging inequality' and 'respecting diversity', and will seek to examine the implications for practice when such values are divergent from those demonstrated in government policy. The paper will make comparisons with international welfare systems to demonstrate the way in which alternative configurations of state welfare can promote a system of social justice that is in greater equilibrium with the professional values of mental health nurses. Finally, the discussion will focus on the options for mental health nurses to either subscribe to government policy or to find compromise solutions that enable attention to remain focused and active on a strong value base of social justice and recovery-focused practice.

Emancipatory practices of nurses in primary health care: the home visit as an instrument of health needs assessment

Objective Identify nurses’ emancipatory practices in primary care, to contribute to the improvement of health care. Method A case study type social research of qualitative nature, in which nurses of a primary health care service unit in São Paulo were interviewed. Results The home visit was identified as a nursing practice possible to be expanded in order to identify social determinants of health, triggering emancipatory practices in the service. This expansion occurred because the design of health care labour intended by the service team changed its focus from the traditional object of health services, the disease. Conclusion First, it is advocated that social policies lead projects with the purpose of improving health needs. On the other hand, the daily labour needs to provide opportunities for reflection and discussion of healthcare projects, leading workers to propose labour-processes targeted to both the social determinants of health and people’s illness.