Nurses are critical to addressing increasing global mental health needs

The International Council of Nurses (ICN), a federation of more than 130 national nursing associations, has published its new Guidelines for Mental Health Nursing.

“In light of rapidly evolving healthcare paradigms, the role of nurses in mental health has never been more important”

Pamela Cipriano

The guidelines call for greater investment and recognition of mental health nursing as an individual specialty, and encourage governments around the world to work to end vast regional disparities in care.

ICN president Dr Pamela Cipriano said in a foreword to the document that she hoped it would demonstrate how nurses were “vital” in tackling the increasing need for mental health care around the world.

“In light of rapidly evolving healthcare paradigms, the role of nurses in mental health care has never been more important,” said Dr. Cipriano.

She added: “Mental health is not just the absence of mental disorders; it is a state of overall well-being in which individuals realize their own capabilities, manage stress, work productively and contribute to communities.

“Mental health nurses are at the forefront of this mission and their expertise and skills are essential to creating responsive and person-centered health care systems that deliver compassionate care.”

Dr. Cipriano said her organization is concerned about the “stigmatization” of mental disorders that continues in some countries.

She argued that a dedicated mental health nursing workforce in every country could help tackle this problem.

She said: “Mental health nurses are uniquely positioned to counter these biases, not only by providing empathetic, person-centered, evidence-based care, but also through public education and advocacy.”

The guidelines, published late last month, outline five broad objectives that all countries must adhere to when organizing their mental health nursing workforce.

The first is to “integrate” mental health education into undergraduate nursing curricula so that all nurses – not just specialists – have fundamental knowledge in this area of ​​healthcare.

“This foundational competency is critical for early identification, effective referral and management of mental health problems and for the provision of holistic and compassionate care,” the guidelines say.

The ICN then emphasized the importance of a nursing specialty in mental health care, in addition to a population of general nurses with knowledge of the field.

According to the guidelines, this included ensuring that there would be specialist mental health nurses at postgraduate level as well as advanced mental health nurses.

The ICN said these advanced nurses should have at least a master’s degree and be deployed to treat patients with mental health comorbidities, implement “nuanced” interventions for these patients and act as leaders with more autonomy than the average nurse in mental health care.

Third, the ICN called for a general investment in mental health, and mental health in particular, from governments and providers around the world.

This investment should include a commitment to “building a robust mental health nursing workforce,” including funding the implementation of advanced practice mental health nurses, the ICN said.

It also said investment was needed to address current gaps in the nursing workforce, including in education and ongoing professional development structures to ensure nurses are “highly skilled and competent”.

The fourth standard outlined by the ICN called for mental health nurses to “stand up” for human rights in mental health settings by addressing stigma, which Dr. Cipriano warned patients about.

“The ICN advocates the essential inclusion of sessions on the needs and rights of people with mental health problems in undergraduate nursing education, requiring co-presentation by people with lived experiences of mental health problems,” the report said.

“The ICN also advocates that education programs include evidence-based stigma reduction competencies so that future nurses can effectively address and counter stigma and discrimination faced by patients and clients.”

Finally, the council said it was “imperative” that governments around the world ensured that the mental health specialty – as a separate specialty from the rest of nursing – was formally recognised.

This should include “rigorous accreditation”, setting standards for mental health nurses and “elevating” the position of the specialty in society.

Following the publication of its guidelines, the ICN attended a meeting World Health Organization workshop on the implementation of pre-registration in mental health and substance use for health professionals.

During the event were Espen Gade Rolland, the Norwegian Nurses Organization leader and contributor to the ICN Guidelines, reiterated calls to convince governments of the importance of mental health nursing.

“Nurses are on the front lines of healthcare, providing a continuum of care that includes compassion, empathy and unwavering commitment to more humane, effective and inclusive healthcare services,” Mr Rolland said, promoting the new guidelines.