To cope with the mental health crisis looming in the wake of COVID-19, Australia must develop novel approaches but also revisit others that are tried and tested. Boosting the number of specialist mental health nurses and ramping up tertiary education to fill future roles should be a major priority.
In his $48.1 million pandemic pledge for additional mental health support, Prime Minister Scott Morrison made no mention of funding additional mental health nurse training or places in our public and private systems. Yet these hardworking nurses will be at the frontline as Australia responds to the 30 per cent spike in mental health conditions being forecast.
In coming months, and years, we expect to see hundreds of thousands of people experiencing mental health issues for the first time, especially younger Australians and those who have never before had to contend with disruptions to their education, unemployment, job losses, and financial and housing stress.
But our current mental health system is already overstretched and under-resourced. People with pre-existing mental health conditions are experiencing loneliness and dislocation due to our nation's social distancing rules. Many are already forgoing regular screening and are unable to access the preventive support services they depend on every day. These people will be the ones in greatest need when the threat of COVID-19 is over.
As a mental health nurse of 30-plus years' experience, I've made a career of advocating for the most vulnerable in our community. As a board member of Billabong Clubhouse in Tamworth, a community organisation that services about 100 people with mental health conditions in the community, I am seeing how difficult it can be to adequately service clients under current conditions. These are people who were facing significant social challenges and disadvantage before coronavirus; now they are at serious risk.
We know that feelings of anxiety and anger, as well as other symptoms, are exacerbated or aggravated during times of stress. Without face-to-face support, many people living in the community with pre-existing mental health conditions are feeling more alone than ever. Even if they did possess a computer or smartphone, few would have the necessary skills to access the telehealth services that Mr Morrison has recently been spruiking.
In recent weeks various health experts have suggested rolling out additional home-based and community care, and establishing pop-up mental health hubs and safe spaces where Australians can seek support without having to attend hospital emergency rooms, even training Centrelink staff in suicide prevention. Where is the workforce for these services going to come from? With the worst yet to come socially and economically, we need to be investing now in growing the network of specialist mental health nurses in our hospitals and communities.
These are nurses capable of assessing clients, helping them to make immediate lifestyle changes, and observing medication use and its efficacy. Importantly, they also serve as a vital conduit between clients and their families and other health service providers. Over the past 10-20 years, recognition of the important role undertaken by mental health nurses has declined, and their numbers along with it. This coincided with the loss of specialist mental health nurse registration in the 1990s, and, since then, many universities have moved to generalist nurse education, containing very limited mental health content.
The few interested in specialising in mental health nursing now have to gain an additional Graduate Diploma in Mental Health Nursing as a minimum qualification.
With health authorities around the country now investigating how to respond meaningfully to the COVID crisis, it's time to rediscover the value of our mental health nurses, without delay.
Because the workforce of which I have been a proud part is ageing. Once my generation of nurses is gone, who will take up the mantle unless specialty courses are once again developed, endorsed and funded?
As a mental health nurse, my expertise has been valued by the World Health Organisation, the International Council of Nurses and AusAid. It's time it was valued by Australian society, too. The health and wellbeing of our clients and the communities we serve depends on it.
Kim Usher is a Professor of Nursing at the University of New England. She has spent most of her academic career researching aspects of mental health, including the psychosocial impacts of emergencies and disasters.
With the worst yet to come socially and economically, we need to be investing now in growing the network of specialist mental health nurses in our hospitals and communities.