Tag Archives: education

Movies, Myths, Mistakes

The Cairns Post, 14th August 2003:

my say 1 140803As if schizophrenia isn’t enough of a burden to those who have it, they also have to put up with the myths and misunderstandings that accompany it, and the discrimination that follows.

So, let’s try to get some of the facts about schizophrenia right.

Probably the most common myth is that schizophrenia means split personality. Comparisons to Jekyll and Hyde are commonplace, but utterly wrong.

In Latin schizophrenia means split mind. This refers to the split between perceiving the world in the way most of us do and perceiving it in other ways.

To illustrate, someone with schizophrenia may interpret everyday events as having significance beyond their intent.

In health, our jargon terms for these sorts of symptoms are delusional beliefs and/or ideas of reference.

my say 2 140803In the film Angel Baby the main character sought special meaning from a game show. I have met plenty of people with schizophrenia and haven’t heard anything quite like that, but then I don’t have to make a living by entertaining people either.

I think what the movie-makers were doing was jazzing-up and stylising the experience of perceiving the everyday in another way.

Speaking of jazzing-up and stylising, A Beautiful Mind certainly did a good job with making paranoia look exciting (it’s not).

Perhaps because movies are visual, this film gave the impression the main character was experiencing his paranoia as a visual experience.

Some people with schizophrenia do have paranoid beliefs and delusions when they are unwell. Nobody I’ve met has described this visually, although quite a few have spoken about hearing things, usually voices,.

It seems these auditory hallucinations are an intrusive and exaggerated version of what all of us experience when we have those little conversations with ourselves throughout the day.

From what I’ve heard, most people’s idea of what a mental health ward looks and functions like comes straight out of One Flew Over The Cuckoo’s Nest.

Anyone who has been inside our local mental health unit at CBH will be able to tell you that it is a modern, light-filled place where there’s direct access to fresh air from just about every room.

In my opinion, the layout and design is the best of all the wards in the hospital.

Finally there’s the violence myth. Hollywood has created a perception that schizophrenia means danger.

I don’t associate violence with schizophrenia at all. I know that on occasions tragic things have happened, but this is rare.

I’ve met dozens of people with schizophrenia who would not  hurt a fly.

I guess if you’re making movies you’re not interested in a story about an ordinary-looking person doing everyday stuff in a pretty average way, other than taking medications to control uninvited symptoms.

Final Notes

Back in 2003 a journalist from The Cairns Post invited me to submit this article for the My Say column (a daily feature presenting the views of a cross-section of the community). The article’s reference to man’s inhumanity to man is in the context of current events at the time – it was published during the second week of the war in Iraq.

As I was identified as an employee of a local hospital, at the time of publication the content of the article had to be approved by the hospital’s media department. The media department approved the article without changes to content.

In 2003 I used some phrases that I find a bit jarring now. I was tempted to correct it in this 2014 version, but decided it was more authentic to leave the original unaltered.

Anyway, I stumbled across the very-low-resolution JPG version of the article today and thought it might be worth reprising. Stigmatising representations of schizophrenia still pop-up in Hollywood, – this is a tiny, inadequate bit of counter-balance.

As always, your feedback is welcome in the comments section below.

Paul McNamara, 26th October 2014

Short URL:  meta4RN.com/movies

Originally:
McNamara, Paul (2003). Movies, myths, mistakes. The Cairns Post, 14 Aug 2003, pg 13.

Defending Mental Health in Nursing Education

NHS

The Guardian (UK ed), 29 Sep 2014

There was an article in The Guardian (UK edition) recently where a nurse described how ill-equipped they felt to support patients experiencing mental health difficulties. The article included the startling information that, “My nursing course, which I think was excellent, contained no more than three days structured education on caring for patients with mental health problems.”

Umm. That wasn’t an excellent nursing course. That’s a crap nursing course.

Look, us Aussies like to tease the Brits about their weather and cricket team every chance we get, but I’m not accustomed to criticising their nursing courses. The truth is, I do not know enough about nursing courses in the UK to hold any strong opinions about how good or bad they are.

That said, I wonder what the general public would think of hospitals being staffed by nurses who had undertaken, as reported, a three year nursing course that includes only three days of teaching in mental health. I am glad that doesn’t happen in Australia.

Dumbing Down is Dumb

Since July 2000 most of my work has been about supporting mental health care in the general health settings as Consultation Liaison CNC (more about that here) and as Perinatal Mental Health CNC (more about that here). These roles have direct clinical input, but also have a lot to do with supporting general nurses and midwives to feel more confident and become more skilled at providing direct clinical care to people experiencing mental health difficulties. It’s inevitable that they’ll need these skills – a significant proportion of people who access general hospitals and/or maternity services also experience symptoms of depression, anxiety etc. Dumbing-down mental health education for general nurses and midwives is dumb.

elistIn August 2012 a Mental Health First Aid (MHFA) instructor proposed using MHFA as inservice education for hospital-based nurses. I mounted my high horse to defend the depth and quality of nursing education sprouting the opinion that MHFA is not suitable training for RNs. My rant went along the lines of it’s great training for many community and professional groups, but it’s inadequate for those working in health role. Undergraduate nursing programs have more than the 12 contact hours that MHFA offers, and we should re-awaken/build-on that education. Nurses in particular need to know a bit about:

  • symptom detection
  • meanings/implications of diagnostic groups
  • medication effects and side-effects
  • the biopsychosocial model of mental health
  • social determinants of health
  • risk assessment/management
  • emotional intelligence and therapeutic use of self

confpresTo give MHFA their due, they have never claimed their training to be an alternative to formal nursing education (others have). MHFA does a good job at informing first responders, but does not address mental health in a manner suitable for a frontline clinician. There is a community expectation that nurses and midwives will have a depth of understanding of mental health beyond that of the general community, beyond basic fist aid.

This conversation started off as a discussion in the workplace, then became a topic of discussion on the Australian College of Mental Health Nurses e-lists, then morphed into a conference presentation and, more recently, was articulated as this journal article:

Happell, B., Wilson, R> & McNamara, P. (2014) Undergraduate mental health nursing education in Australia: More than Mental Health First Aid. Collegian (2014), http://dx.doi.org/10.1016/j.colegn.2014.07.003

Happell, B., Wilson, R. and McNamara, P. (2014) Undergraduate mental health nursing education in Australia: More than Mental Health First Aid. Collegian (2014), http://dx.doi.org/10.1016/j.colegn.2014.07.003

Anyway, I guess there are two points to this blog post:

One: Quality Control
Let’s make sure that we continue to defend the quality and depth of undergraduate nursing and midwifery training in Australia. We must never let it slip like the UK example of just three days training in three years. That is woefully inadequate.

Two: Speak Up 
If you’re a nurse or midwife with strong opinions about a subject, it doesn’t hurt to discuss these opinions online. As per this example, a discussion held online morphed into a conference presentation and a journal article. For me, anyway, the difference between it being a rant and a paper was the interest and input from a couple of Nursing Academics: Brenda Happell (@IHSSRDir on Twitter) and Rhonda Wilson (@RhondaWilsonMHN on Twitter).

References

Happell, B., Wilson, R. L. & McNamara, P. (2013). Beyond bandaids: Defending the depth and detail of mental health in nursing education. Paper presented at the Australian College of Mental Health Nurses 39th International Mental Health Nursing Conference Perth, Western Australia, Australia. Abstract in International Journal of Mental Health Nursing, Vol 22, Issue Supplement S1, pp 11-12 http://onlinelibrary.wiley.com/doi/10.1111/inm.2013.22.issue-s1/issuetoc

Happell, B., Wilson, R. L. & McNamara, P. (2014) Undergraduate mental health nursing education in Australia: More than Mental Health First Aid. Collegian (In Press) http://dx.doi.org/10.1016/j.colegn.2014.07.003

End

Thanks for reading this far. As always, your feedback is welcome in the comments section below.

Paul McNamara, 21st October 2014

Short URL: meta4RN.com/defend

Free Open Access Mental Health Education for General Nurses and Midwives #FOANed

If you’re a nurse or midwife, and own an internet-enabled device you have unprecedented access to information.

Information + motivation = education.

Borrowing from the very successful #FOAMed initiative, recently there has been a flurry of activity regarding Free Open Access Nursing Education (aka #FOANed).  That is:

Free
Open
Access
Nurse
education

The #FOANed hashtag makes it’s easy to share info and resources via social media. If you’re cruising Twitter, Facebook, Google+ or even Instagram, have a look for the #FOANed hashtag.

Still not sure what the #FOANed hashtag is all about? Perhaps it’s just easier to see for yourself via this Storify (click here).

Mental Health #FOANed

Anyway, in the spirit of #FOANed, here are four suggestions for free open access nursing education re mental health for general nurses and midwives (click on each picture for more info):

1. Physical and Mental Health Care via Australian College of Mental Health Nurses:

2. Mental Health Liaison in General Hospitals via New South Wales Health:

inkysmudge.com.au/eSimulation/mhl.html

inkysmudge.com.au/eSimulation/mhl.html

3. Perinatal Mental Health Training for Midwives via Monash University:

perinatal.med.monash.edu.au

perinatal.med.monash.edu.au

4. MIND Essentials via Queensland Health:

Obviously, this is not an exhaustive list of the mental health #FOANed available online, but hopefully it’s enough to get you started if you’re looking for some CPD/info.

Please feel free to add your suggestions for other free open access nursing education re mental health in the comments section below.

Paul McNamara, 20th October 2014

Short URL: meta4RN.com/FOANed