Unfortunately, some of the issues and challenges highlighted are still with us. The physical environments in some services are inappropriate and unfit for care, life in some community housing still mundane and meaningless, ECT still being used by ECT enthusiasts, and poly-pharmacy remains a major issue of concern. There is still a sense throughout a large part of our society, including some people who work in the mental health services, that people who use the services do not have a right to information or to be involved in their care. Indeed the power to label people and use that label to vindicate and justify behaviour remains ever present.
Changing mental health services requires both a societal and community endeavour. In that sense we all have a responsibility to demand a dignified and respectful mental health service. While there is a need to adequately fund multi-disciplinary teams, modern premises within communities and creative approaches other than pharmacological, change and reform are not just about more funding. Change requires a real and genuine shift in attitude and power from those who are involved in policymaking, funding, service planning, as well as all who work in the mental health services.
Mental health nurses form the largest group of practitioners working in the mental health services. As such, they are in an excellent position to make a major contribution to the required change and reform. Many are already leading the way, working creatively and in partnership with service users and family members. However, it is now time for all mental health nurses to display leadership and challenge the over reliance on any singular approach to mental health care. Mental health nurses have both a professional and moral obligation to be reflective about the care they deliver, to demand improvement and to speak up for the rights of people experiencing mental distress. If mental health nurses stand beside and with people who use services, they can be a powerhouse for change.
Dr Agnes Higgins
Irish Institute of Mental Health Nursing School of Nursing and Midwifery