Tag Archives: mental health

Supporting the person diagnosed with a personality disorder who presents to the Emergency Department following intentional self-harm

About eighteen months ago I was invited to contribute a chapter to a book on Mental Health in Emergency Care. The chapter was to be named “Supporting the person diagnosed with a personality disorder who presents to the Emergency Department following intentional self-harm”.  

Pretty-much straight away I asked Enara Larcombe to co-produce/co-write the chapter with me. Co-production is in keeping with the “nothing about us without us” idea (which has gained a lot of buy-in from senior mental health nurses). My reasons for asking were:

  • It’s good manners
  • It would improve the contribution
  • It would be difficult to write on the subject without including learnings I’ve acquired when working with Enara

As it turns out, in the process of collaboration Enara became the lead author of the chapter. Enara did the lion’s share of the literature search, and contributed some fantastic lived-experience insights. Enara certainly earned lead authorship. After lots of to-ing and fro-ing between us, Enara and I proudly sent off our chapter about a year ago.

The key points of the chapter are:

  • Borderline personality disorder is often misunderstood, and many people who have been given this diagnosis feel that it has stigmatised their care in the hospital and health system. 
  • Intentional self-harm is a complex phenomenon; it does not always indicate a wish to die. 
  • Nurses and other emergency care professionals are well placed to provide both physical and mental health care to the person who presents following intentional self-harm. 

 The learning outcomes we hope the chapter will assist with are:

  • Improve your understanding of the diagnosis of borderline personality disorder and what this means for the person. 
  • Articulate the differences and similarities between a suicide attempt and non-suicidal self-harm. 
  • Describe examples of stigma that the person who self-harms experiences and consider how this might impact on practice. 
  • Identify nursing interventions and practices that are helpful to the person who self-harms.   
  • Describe the communication and interpersonal skills that can be deployed to support the person who intentionally self-harms/who has been diagnosed with borderline personality disorder. 

So What?

Today I learned that the book with our chapter is available for pre-purchase.

Shit is getting real homies.

From the info available on the website, it looks like our chapter has been renamed from “Supporting the person diagnosed with a personality disorder who presents to the Emergency Department following intentional self-harm” to “Emergency Department: Person with personality disorder presenting with deliberate self-harm”.

I prefer the kinder, more respectful “Supporting the person diagnosed with..” bit, but anyway…

Anyway, I’m pleased-as-punch to be a co-author of a chapter in a book. Not perfoming at quite the same level as Tim Winton or JK Rowling, but for me it’s still a big deal.

Chapter Reference

it’s a pain-in-the-arse citing chapters in reference lists, so in the interests of encouraging you to read and cite the chapter, let’s keep it copy-and-paste easy:

APA
Larcombe, E. & McNamara, P. (2022) Emergency Department: Person with personality disorder presenting with deliberate self-harm. In P. Marks (Ed), Mental Health in Emergency Care, (pp. 131-143), Elsevier

Harvard
Larcombe, E & McNamara, P 2022, ‘Emergency Department: Person with personality disorder presenting with deliberate self-harm’, in P. Marks (ed), Mental Health in Emergency Care, Elsevier (pp. 131-143)

MLA
Larcombe, Enara & McNamara, Paul. “Emergency Department: Person with personality disorder presenting with deliberate self-harm.” Mental Health in Emergency Care, edited by Peta Marks, Elsevier, 2022, pp. 131-143

Q & A

Q: Mental Health in Emergency Care will be on the bookshelves in about three months. Is it the perfect Christmas gift?
A: Yes. Yes it is the perfect Christmas gift. 🙂

Q: How much money do you make for each copy sold?
A: Zero dollars and no cents. 😦

Q: Huh?
A: Academic publishing puts a value on everything except the content creators. ikr

Q: Why skite in August about a book that is not available until November?
A: Because I intend to mothball this website in September. It’s now or never.

Q: Why skite about it all?
A: I was a scrape-through-average student at school. That was a LONG time ago, but still… being published suprises and delights me.

Q: So, do you admit that you’re just bragging?
A: I admit that I don’t hide my light under a bushel. I’ve written about this before [see A Nurse’s Digital Identity]. Get on board. Don’t be mean.

Q: Where do I find out more about the book?
A: www.elsevierhealth.com.au/mental-health-in-emergency-care-9780729544214.html

End Notes

Many thanks to Peta Marks for inviting the chapter contribution; huge thanks to Enara Larcombe for co-producing it.

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

Paul McNamara, 22 August 2022

Short URL meta4RN.com/chapter

Mental Health Nursing making an impact

Recently I trawled through the history of the International Journal of Mental Health Nursing (IJMHN) – if you’re curious please see this editorial and this blog post.

Amongst the things revealed was the encouraging upward trend in the Impact Factor – a metric that reflects how many citations individual academic journals attract over a two year period. I was especially encouraged that a targeted social media strategy, together with the increased volume of articles, coincide with the Impact Factor upward trend since 2017.

Today this arrived in an email:

The 2022 Journal Citation Reports were released overnight, and I am very pleased to let you know that International Journal of Mental Health Nursing’s 2021 Impact Factor is 5.100 – a significant increase from 3.503 for 2020. This result places the Journal in the rankings: 2/125 (Nursing), 2/123 (Nursing (Social Science)), 57/155 (Psychiatry), 43/142 (Psychiatry (Social Science)).

Alison Bell, Journal Publishing Manager, Wiley, email of 29 June 2022

That is – to put it bluntly – bloody amazing!

Don’t believe me? Look at the chart below…

International Journal of Mental Health Nursing Impact Factor (2010 – 2021)

The journal had very humble beginnings. It was just an idea amongst a few Mental Health Nurses in Australia in July 1978. The first issue consisting of just two articles and editorial followed in September 1980 (source and source).

2021 data reveals this humble little journal is now ranked the second most impactful nursing journal on the planet.

Amazing.

Mental Health Nursing is punching above its weight. Mental Health Nursing ranks 5th as principal specialty, after Aged Care, Medical, Surgical and Peri-operative (source and source). Yet, we have a journal that rates 2nd most cited nursing journal, behind the International Journal of Nursing Studies (IJNS).

That’s something to celebrate – not just for the authors, reviewers and editors who put in the hard work to make it happen – but for all Mental Health Nurses.

End

Please spread word about the impact of the International Journal of Mental Health Nursing – it’s a good news story 🙂

Paul McNamara, 29 June 2022

Short URL meta4RN.com/impact

IJMHN LinkedIn post

IJMHN Facebook post

Happy Anniversary International Journal of Mental Health Nursing

Since late 2016 I have been the Social Media Editor for the International Journal of Mental Health Nursing (IJMHN). If you’re interested in how that started, see meta4RN.com/IJMHN. The years that have followed have resulted in heaps of Tweets, Facebook posts and LinkedIn updates. As a byproduct, I’ve been keeping a closer eye on the journal than I would have otherwise, and stumbled across the fact that 2022 marks the anniversary of three important milestones in the journal’s history:

✅ 30 years as a fully refereed journal (1992)
✅ 20 years as the International Journal of Mental Health Nursing (2002)
✅ 10 years on social media (2012)

That observation has been explored and elaborated-on via my first (and probably only) editorial. Please read and share the article far and wide:

McNamara, P. (2022), Happy anniversary IJMHN. International Journal of Mental Health Nursing. https://doi.org/10.1111/inm.13025

Below are some abbreviated highlights and a video summary from the editorial.

What’s in a name?

1980 Journal of the Australian Congress of Mental Health Nurses
1990 Australian Journal of Mental Health Nursing
1994 Australian and New Zealand Journal of Mental Health Nursing
2002 International Journal of Mental Health Nursing

Figure 3. Evolution of the Journal (1980–2022). https://doi.org/10.1111/inm.13025

Editors

1980 Dennis Cowell
1982 Ron Dee
1986 Owen Sollis
1987 Linda Salomons
1988 Andrew King
1990 Michael Clinton
1999 Michael Hazelton
2004 Brenda Happell 
2015 Kim Usher

I have not attempted to discover the names of everyone who has served on the journal’s editorial board – there would many dozens (in the hundreds?) of people of who have contributed over the years. For what it’s worth, below is a May/June 2022 snapshot of the editorial board.

Online list: https://onlinelibrary.wiley.com/page/journal/14470349/homepage/editorialboard.html

Beyond the Walled Gardens

It is sensible to promote the work of IJMHN authors/researchers beyond the walled gardens of mental health nursing and academia. Below are links to the journal’s first excursions from behind the paywalls and exclusion zones that prevent people seeing the work and research of mental health nurses, and out to ‘the village square’ that is social media:

Twitter 2012 bit.ly/IJMHNTwitter
Facebook 2013 bit.ly/IJMHNfacebook
LinkedIn 2021 bit.ly/IJMHNLinkedIn

As I’ve argued previously (here and here), there’s not much value in spending weeks/months/years doing research, then pushing through the tedium of academic writing, and finally jumping through the flaming hoops of peer review only for your work to sit around unread and gathering dust. Authors and the institutions that support them should promote the paper to its greatest readership. The IJMHN has a strategy to promote mental health nursing’s research and work on social media – do you?

Figure 4. Example of Altmetric Attention Score. https://doi.org/10.1111/inm.13025

Average Number of IJMHN Articles

2000–2006 = 35 per year
2007–2017 = 62 per year
2018–2021 = 135 per year

Figure 1. Number of IJMHN Articles Published (2000=2021). https://doi.org/10.1111/inm.13025

Making an Impact

The first IJMHN Impact Factor was 1.427 (2010). At time of writing, the most recent available Impact Factor is 3.503 (2020). That’s pretty amazing – the IJMHN is the highest-ranked mental health/psychiatric nursing journal, and is rated as the 5th most cited nursing journal in the world (in a field of 124 nursing journals).

A targeted social media strategy together with the increased volume of articles coincide with the Impact Factor upward trend starting in 2017.

Time will need to pass before we know whether the most recently reported Impact Factor is an anomaly of the pandemic. I make this observation because, at time of writing, the three most cited IJMHN papers are all from 2020, and each of these highly-cited articles discuss contemporary-at-the-time COVID-19 issues (see the “Most Cited” tab here: onlinelibrary.wiley.com/journal/14470349).

Figure 2. IJMHN Impact Factor (2010–2020). https://doi.org/10.1111/inm.13025

Connecting with IJMHN

Website www.wileyonlinelibrary.com/journal/INM
Twitter twitter.com/IJMHN
Facebook www.facebook.com/IJMHN
LinkedIn www.linkedin.com/company/IJMHN


TL;DR

too long; didn’t read?

Watch the video – it’s less than 2 minutes long, and has a cool musical accompaniment (‘Dashed Ambitions’ by Moby, kindly provided gratis via mobygratis.com).

(video made by first making a Prezi)

End Notes

In case you missed it above, here’s the citation and link to the editorial:

McNamara, P. (2022), Happy anniversary IJMHN. International Journal of Mental Health Nursing. https://doi.org/10.1111/inm.13025

And the PDF version is here: onlinelibrary.wiley.com/doi/epdf/10.1111/inm.13025

Thanks for reading this far. I would be grateful if you share either this blog page or – preferably – the article itself. Sharing is caring 🙂

As always, feedback is welcome via the comments section below.

Paul McNamara, 29 May 2022

Short URL: meta4RN.com/happy

Why choose Mental Health Nursing?

This blog post accompanies a chat with 3rd / 4th year James Cook University (JCU) Nurse/Midwife students at an industry presentation day on 12th May 2022. Here is a copy of the slide show I’ll be using for the presentation @ JCU on the day:

Below are snippets and elaborations of the info we will touch-on/discuss on the day. Parking the information online just in case any of the JCU Students want to come back to it, and/or if it happens to be of interest to others.

Slide 1
As part of introducing myself, I’ll also introduce the idea/example of nurses intentionally making themselves visible on social media (eg: linktr.ee/meta4RN). More about that sort of thing here and here.

Slide 2
The day of the JCU student nurse industry presentation = 12th May = Florence Nightingale’s birthday = International Nurses Day.
Coincidence?
Yeah, probably.
But anyway, here’s a link to 20 tweetable fun facts that I like to trot-out to celebrate International Nurses Day: meta4RN.com/nurses2020
Also, check out the #IND2022 hashtag on social media.

Slide 3
Mental Health Nursing is vastly different to other hospital-based specialist nursing roles. I reckon it’s a very good fit for people who are very adaptable. A few years ago Australian researchers coined the ‘Ten P’s of the professional profile that is mental health nursing’:

present
personal
participant partnering
professional
phenomenological
pragmatic
power-sharing
psycho-therapeutic
proud
profound

(Santangelo, Procter & Fassett, 2018)

Slides 4 & 5
Part of what makes Mental Health Nursing different is the structure of public mental health services. Inpatient care is just a small part of the service structure, and there is a lot of emphasis on outpatient/community based services. There are options to specialise (as I have done, more about that here and here), or – as Mental Health Nurses who work in rural and remote areas do – do a little bit of nearly everything on the list of services of slide 5/in the table below.

Intake PointsInpatient/Residential ServicesOutpatient/Community Services
Central Intake Service
Emergency Department
Consultation Liaison Psychiatry Service
Psychiatric Intensive Care Unit
Mental Health Unit
Step-Up/Step-Down Unit
Community Care Unit
Acute Care Team
Continuing Care Teams
Mobile Intensive Treatment Team
Older Persons Mental Health Service
Child & Youth Mental Health Service
Evolve Therapeutic Services
Perinatal & Infant Mental Health
NQ Eating Disorder Service
Forensic & Prison Mental Health
Alcohol Tobacco & Other Drugs
Rural Mental Health
Remote Mental Health
Examples of mental health services/settings

Slide 6
On any given day, less that 1% of people who are open the Mental Health/Alcohol, Tobacco & Other Drugs Service that I work for are receiving specialist psychiatric inpatient treatment. The vast majority of mental health and addiction support and recovery happens in community settings, as evidenced by the data (collected on 12/04/22) below:

Cairns Hospital PICU/MHU Beds, n = 48
Cairns & Hinterland MHATODS Case Load, n = 5531

Slide 7
What do Mental Health Nurses do? Well, it’s pretty varied, but includes:

  • Responding to trauma/people experiencing crisis
  • Assessment – this mostly consists of looking, listening and asking – not necessarily in that order.
  • Coordinating and collaborating with the person and their family to plan and deliver care
  • Liaising with other members of the clinical team and other local services (eg: @CairnsHelp) to ensure holistic, person-centred care
  • Providing support
  • Act as an educator/resource person
  • Provide therapy (eg: Solution-Focused Therapy, Acceptance & Commitment Therapy)
  • Work across clinical and community settings
  • Work anywhere – including rural and remote areas (see: The challenges of mental health nursing in rural Australia)
  • Provide holistic care (ie: specialising as a Mental Health Nurse doesn’t suddenly mean you forget everything you’ve learned as student nurse/RN)
  • Being consumer-focused and trauma-informed
  • Acquiring and using specialised skills and knowledge

More info @ ACMHN.org/what-mental-health-nurses-do

Slide 8
As articulated by Hildegard Peplau (one of the earliest rockstars of Mental Health Nursing) our speciality places a premium on therapeutic use of self, and the therapeutic relationship.

Slide 9
Mental Health Nurse core competencies include:

  • assessment and management of risk
  • understanding recovery principles
  • person- and family-centred care
  • good communication skills
  • knowledge about mental disorders and treatment
  • evaluating research and promoting physical health
  • a sense of humour
  • physical and psychological interventions

(Moyo, Jones & Gray, 2022)

Slide 10
A specialist Mental Health Nurse is a…

  • psychotherapist
  • consumer advocate
  • physical health therapist
  • psycho-pharmacological therapist
  • relationship-focused therapist
  • aggression management therapist

 (Hurley & Lakeman, 2021)

Slide 11
Steps to becoming a Credentialed Mental Health Nurse:

  1. Graduate with an undergraduate degree in Nursing
  2. Complete a Graduate Diploma, Postgraduate Diploma or Masters in Mental Health Nursing
  3. (Optional) Undertake additional training in specific psychological therapies
  4. Successfully apply to be credentialed by the Australian College of Mental Health Nurses –  the peak professional mental health nursing organisation and the recognised credentialing body for Australia’s mental health nurses.

Slide 12
That’s it. Questions? 🙂

Video

Key References/Further Reading

Australian College of Mental Health Nursing acmhn.org

Hurley, J. & Lakeman, R. (2021), Making the case for clinical mental health nurses to break their silence on the healing they create: A critical discussion. International Journal of Mental Health Nursing. doi.org/10.1111/inm.12836

Isobel, S., Wilson, A., Gill, K., Schelling, K. & Howe, D. (2021), What is needed for Trauma Informed Mental Health Services in Australia? Perspectives of clinicians and managers. International Journal of Mental Health Nursing. doi.org/10.1111/inm.12811

McKenna Lawson, S. (2022), How we say what we do and why it is important: An idiosyncratic analysis of mental health nursing identity on social media. International Journal of Mental Health Nursing. doi.org/10.1111/inm.12991

Moyo, N., Jones, M. & Gray, R. (2022), What are the core competencies of a mental health nurse? A concept mapping study involving five stakeholder groups. International Journal of Mental Health Nursing. doi.org/10.1111/inm.13003

Santangelo, P., Procter, N. and Fassett, D. (2018), Mental health nursing: Daring to be different, special and leading recovery-focused care?. International Journal of Mental Health Nursing. doi.org/10.1111/inm.12316

End

As always, feedback is welcome via the comments section below.

Naturally, if you think it will be of interest to any nurse/nearly-nurse you know, you are very welcome to forward the info on by whatever means you see fit. 🙂

Paul McNamara, 15th April 2022

Short URL meta4RN.com/JCU

Q: RUOK? A: Not really. I’m a nurse.

09/09/21 = RUOK Day. More about that here: www.ruok.org.au

Ask a nurse how they are and they’ll probably give a positive answer: “good thanks”, “ticketyboo” and “living the dream” are favourite reflex answers in the hospital where I work.

Scratch beneath the surface though, and the overwhelming answer to the question “Are you OK?” amongst health professionals – especially nurses – in September 2021 would be: “No. Not really.”

Nurses know we’ve been lucky to have secure employment at a time when many others have not. However – as a profession – we are tired and anxious. This is evidenced by articles in the mainstream press, posts on social media, and research published in academic, peer-reviewed, journals.

Source: https://pbfcomics.com/wp-content/uploads/2018/06/PBF-Youll_Be_OK.png

There is some stuff we can do by ourselves.

There is some stuff to manage stress that we can do by ourselves. Simple things like mindfully washing our hands, for instance. I first read about this idea via Ian Miller (aka @impactednurse and @thenursepath) in 2013. When Ian withdrew from the online space, I reprised the idea in a 2016 blog post:

Then refreshed the idea in March 2020 when the pandemic hit Australia:

And made a short video version to accompany the blog post:

The mindful handwashing idea for nurses, as I saw for myself for the first time yesterday, has now been published in a text book:

Being published in a text book makes an idea legit, right? 🙂

Anyway – if you haven’t already – try building-in something like mindful handwashing into everyday practice. Something that you can do for yourself, by yourself, while you’re at work.

On behalf of your boss, I can assure you that she/he/they does not want you to burnout – nurses have never been more valued than they are in September 2021. She/he/they needs you. If taking a couple of extra seconds to wash your hands helps you take care of yourself, your boss will be happy that you’re using that time productively.

There is some stuff that we need to do with others.

Nursing is a team sport. So is self-care.

Those familiar with meta4RN would know already that I’m likely to bang-on about clinical supervision. So as not to disappoint, here you go:

And the other thing that I want to remind readers about is Nurse & Midwife Support – a 24/7 national support service for Australian nurses and midwives providing access to confidential advice and referral.

I was chatting with one of the NMSupport staff members recently, and her only suggestion was to encourage colleagues to NOT leave it until they’re feeling overwhelmed before phoning. It seems as if many of us have the bad habit of not asking for support until we’re in crisis. Now that I think about it, phoning a week or two BEFORE the crisis is probably a better idea. 🙂

Phone NMSupport on 1800 667 877, and/or visit their website (www.nmsupport.org.au), Facebook (www.facebook.com/NMSupportAU), Insta or Twitter:

One last thing (an overt plug for a friend’s book chapter).

In case you missed the subtle plug above, please let me be more explicit about promoting the chapter by a Consultation Liaison Nurse peer and friend, Julie Sharrock. The chapter title and book title say it all:

Sharrock, J. (2021). Professional self-care. In Foster, K., Marks, P., O’Brien, A. & Raeburn, T. (Eds.). Mental health in nursing: Theory and practice for clinical settings (5th ed.). (pp. 86-105). Elsevier Australia. www.elsevierhealth.com.au/mental-health-in-nursing-9780729

I really like that this chapter in a text book by nurses for nurses acknowledges that we need to care for ourselves to care for others. Although it flies in the face of that ridiculous hero narrative, it is legitimate for nurses to seek a long-lasting, satisfying and meaningful career. Julie’s chapter speaks to that, and provides explicit information on strategies for nurses to use.

I recommend that you have a read of the evidence-based ideas for sustaining yourself and your career that the chapter contains. Perhaps your local hospital/university already has a copy of the book.

End.

That’s it. I just wanted to make a point that not all of us are OK. Unlike the caravaner below, not all of us can “Just deal with it Trish.” Well, not ALL the time, anyway.

@meta4rn

“Just deal with it Trish.” #JustDealWithItTrish Trish and Rex: stranded Victorians interviewed in an Albury caravan park, 09/09/21 #RUOKday #RUOK

♬ original sound – Paul McNamara

As always, you are very welcome to leave feedback in the comments section below.

Paul McNamara, 9 September 2021

Short URL: meta4RN.com/RUOK

Mental Health in the General Hospital (video version)

A couple of weeks ago I was an invited speaker at the ANMF Vic Branch & NMHP Wellness Conference. The session was titled “Mental Health in the General Hospital”. Regular visitors to the meta4RN.com blog would have seen the accompanying web page to the presentation (here it is: meta4RN.com/ANMFvic).

This week the recording of the conference became available. I’ve snipped my session into a YouTube video and saved it here so it’s easy to find and share with those who have expressed an interest in seeing it (thanks Mum 🙂).

For reasons I don’t understand the video version of the presentation is blighted by a couple of static black boxes; these are not visible at all when viewing the actual Prezi. Mysterious. 🤷‍♂️

My noggin is a bit blurred/asynchronous when on screen – that would be due to the NBN being slowed to a crawl by copper wire, I guess. Fibre to the node, eh? 🙄

Those couple of things aside, it’s interesting (for me) to see the video version back. Yes, it’s a bit embarrassing, but it also shows me the sort of things I should try to improve for future presentations. Less face-touching, for instance. 😕 

Still image from the video. L-R: Eduardo D’Bull, Stone Woman by Ruth Malloch, Paul McNamara and Bessie D’Cow.

End

That’s it. No need to ramble any further – this blog post is all about the video (feat. Eduardo D’Bull and Bessie D’Cow). 📺 🐮 🐄

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

Paul McNamara, 29 May 2021 

Short URL meta4RN.com/vid

Mental Health in the General Hospital

On Friday 7 May 2021 I’ll be presenting at the ANMF Vic Branch & NMHP Wellness Conference. My session is tilted “Mental Health in the General Hospital”, and is followed by a session by Magda Szubanski!

I’m not making a fuss about presenting back-to-back with one of Australia’s most loved actors, although I may have mentioned it on Twitter…

and Facebook www.facebook.com

and Instagram www.instagram.com

and LinkedIn www.linkedin.com

But otherwise, I hardly it mentioned it all. 🙂

Anyway, this page is a place to link to the Prezi and the presentation content for the session. Because the presentation draws heavily on previous work I’ve done, the reference list is ridiculously self-referential.

Prezi https://prezi.com/p/mk9smhldjhnx/mental-health-in-the-general-hospital/

CLPS Nurses (WTF?)

A random sample of journal articles by/about Nurses working in an Australia Consultation Liaison Psychiatric Service (not pretending/trying to be an exhaustive list).

Dawber, C. (2013), Reflective Practice Groups for Nurses. International Journal of Mental Health Nursing, 22: 135-144. https://doi.org/10.1111/j.1447-0349.2012.00839.x

Harvey, S.T., Fisher, L.J. and Green, V.M. (2012), Evaluating the clinical efficacy of a primary care‐focused, nurse‐led, consultation liaison model for perinatal mental health. International Journal of Mental Health Nursing, 21: 75-81. https://doi.org/10.1111/j.1447-0349.2011.00766.x

McMaster, R., Jammali‐Blasi, A., Andersson‐Noorgard, K., Cooper, K. and McInnes, E. (2013), Research involvement, support needs, and factors affecting research participation: A survey of Mental Health Consultation Liaison Nurses. International Journal of Mental Health Nursing, 22: 154-161. https://doi.org/10.1111/j.1447-0349.2012.00857.x

McNamara, P., Bryant, J., Forster, J., Sharrock, J. and Happell, B. (2008), Exploratory study of mental health consultation‐liaison nursing in Australia: Part 2 preparation, support and role satisfaction. International Journal of Mental Health Nursing, 17: 189-196. https://doi.org/10.1111/j.1447-0349.2008.00531.x

Sharrock, J., Grigg, M., Happell, B., Keeble‐Devlin, B. and Jennings, S. (2006), The mental health nurse: A valuable addition to the consultation‐liaison team. International Journal of Mental Health Nursing, 15: 35-43. https://doi.org/10.1111/j.1447-0349.2006.00393.x

Sharrock, J. and Happell, B. (2002), The psychiatric consultation‐liaison nurse: Thriving in a general hospital setting. International Journal of Mental Health Nursing, 11: 24-33. https://doi.org/10.1046/j.1440-0979.2002.00205.x

Wand, T., Collett, G., Cutten, A., Buchanan‐Hagen, S., Stack, A. and White, K. (2020), Patient and clinician experiences with an emergency department‐based mental health liaison nurse service in a metropolitan setting. International Journal of Mental Health Nursing, 29: 1202-1217. https://doi.org/10.1111/inm.12760

“The 7 D’s”
Dementia
Delirium
Depression
Deliberate self-harm
Disturbed behaviour
Dangerous Diets
Dodgy drugs

McNamara, P. (2014) A mental health nurse in the general hospital, blog post published by ‘My Health Career’ on 12/05/14, retrieved 03/05/21 www.myhealthcareer.com.au

Other resources re CLPS Nurses in Australia

Top Tips for CL Nurses (PDF)

Australian College of Mental Health Nurses Consultation Liaison Special Interest Group (aka ACMHN CL SIG) acmhn.org/home-clsig

Pivot (verb)

A word that is more palatable than “change”, “adapt” and “survive”; came in to common use during the early days of the COVID-19 pandemic.

Distracted-boyfriend meme
– background/history wikipedia.org/wiki/Distracted-boyfriend_meme
– generator imgflip.com/memegenerator/Distracted-Boyfriend

The Other PPE

McNamara, P. (2020) Positive Practice Environment (the other PPE), blog post written 01/04/20, retrieved 03/05/21 meta4RN.com/PPE

Clean Hands. Clear Head.

McNamara, P. (2020) Clean Hands. Clear Head., blog post written 25/03/20 with an update on 08/12/20, retrieved 03/05/21 meta4RN.com/head

End Notes

Many thanks to Nursing and Midwifery Health Program Victoria and Australian Nursing & Midwifery Federation – Victorian Branch for inviting me to present.

Thanks to QR Code Monkey for providing a free, easy-to-use, QR code generator that allows for a logo to be inserted.

Something that pandemic has provided is ubiquitous uptake of QR codes, which makes this 2012 idea of deploying complex health information via a QR code more practical/relevant than ever. More info on this via the video below and/or ye olde blog post: meta4RN.com/QRcode

Thanks for visiting. As alway, feedback is welcome via the comments section below.

Paul McNamara, 3 May 2021

Short URL meta4RN.com/ANMFvic

My First Podcast

My first podcast has been released by Nurse & Midwife Support to coincide with RUOK Day. 

It’s about suicide and nurses and mental health and social media and stuff.

You can access it by clicking here, or on the picture below, or go straight to the platform of your choice: SoundCloud + Apple + Spotify + PodLink

Many thanks to Mark Aitken at Nurse & Midwife Support for interviewing me back on 10th October 2019 (World Mental Health Day) for this podcast.

For those who don’t listen to podcasts, below is a copy of the transcript that I have pirated from this webpage:

Mark Aitken: I’m at the Australian College of Mental Health Nurses 45th International Conference in Sydney. My guest today is Paul McNamara: Clinical Nurse Consultant, Consultation Liaison Psychiatry Service at Cairns and Hinterland Hospital and Health Service. Welcome, and hello Paul!

Paul McNamara: G’day Mark, thanks for having me.

MA: It’s great to have you here today Paul. Today, we will discuss suicide and support for nurses, midwives and students at risk of suicide and following the death by suicide of a colleague. Paul, as you report in your blog on your website (meta4RN.com which I’ll get you to talk about shortly) you cite a retrospective study into suicide in Australia from 2001 to 2012 that uncovered these alarming four findings:

  1. Female medical professionals are 128% more likely to suicide than females in other occupations.
  2. Female nurses and midwives are 192% more likely to suicide than females in other occupations.
  3. Male nurses and midwives are 52% more likely to suicide than males in other occupations.
  4. Male nurses and midwives are 196% more likely to suicide than their female colleagues.

They’re incredible statistics. Quite disturbing I think, Paul. Would you please tell our listeners a bit more about that? But also, your role and meta4rn.com and why you wrote the blog about suicide that you’ve titled Nurses, Midwives, Medical Practitioners: Suicide and Stigma.

PM: Sure. The hospital that I work in, I’ve been there off and on for nearly 20 years now. Back in the early 2000’s three of the nurses who worked there died by suicide. That was a bit of a shock to us all. It happened within a fairly short amount of time, about 18 months I think it was. It felt like knock, after knock, after knock. A lot of us, myself included, were standing around looking at each other. Looking at our colleagues on the nursing team and thinking, “Oh Christ, what could we have done better? What could we have done differently?” That’s really stuck with me. Then with my role, I work as a mental health nurse in the general hospital. Not everyday day of the week, but certainly every week of my working life I will see people who have attempted to take their own lives and have survived it and been admitted (medically or surgically) to be patched up. While that’s happening, I’m providing the mental health input.

I guess that suicide is just an everyday part of my working life. A bit more than I would like, sometimes, to be honest. When it effects my colleagues, that gives it an extra resonance. It was with those thoughts bouncing around my head when I saw that paper come out with that data. That was published in November 2016, it was written by a pretty impressive bunch of people. They were all doctors on the team. I think one of them was a PhD doctor, not a medical doctor, but the rest of them were medical doctors from various specialties. The bits of that story that were picked up by the mainstream media were about the escalated risk to doctors of suicide. The mainstream media didn’t really pick up on the escalated risks to nurses and midwives, which were actually a bit higher than the risks for female doctors. Interestingly, male doctors don’t kill themselves at a greater rate than blokes in other professions. So, it was very much about nurses and midwives. As we know, most nurses and midwives are females. The whole thing has just got a bit of a resonance for me. It worries me. I guess the title that I gave it, it was speculative. I wonder about the stigma around suicide as we (nurses and midwives) get exposed to suicide stuff so much. I wonder whether we stigmatise ourselves around that. That was what the blog post was all about.

MA: Thanks Paul, I think you make some really interesting points there. Would you tell our listeners a bit about meta4rn.com? People will obviously want to access this blog once they listen to this podcast. I think it’s a really important blog, so what is it and why did you start it?

PM: This could be the cleverest thing here today Mark..

-Laughs-

MA: Apart from us.

PM: That’s right. Meta4rn.com is a homophone, it’s a bit of a play on words. It can be read two ways: metaphor, as in using an analogy to get a point across. A lot of education happens that way, where we use metaphors. I think particularly amongst nurses and midwives, you’ll be at a nursing station saying, “You do it this way because it’s a bit like a…” We use that kind of language a lot. We use metaphors a lot, and I threw on RN at the end because that’s what I am, an RN. Another way to break down that name is meta, which is like if we were having a conversation about another conversation. That would be a meta conversation. A lot of the stuff I talk about on the blog is a conversation about nursing conversations. That was where the idea for the name came from. Every now and again, I feel a bit self-conscious about it because it is a little bit wanky.

I came about setting up that blog because at the time I was working in perinatal mental health. By definition, my patients were women aged somewhere between 15 and 45. That demographic had the best and quickest uptake of social media and smartphones. This is going back to 2009/2010 when I first started mucking around in that space. If you remember back to then, iPhones were still a relatively new idea. I think they had been on the market in Australia for a year and a half, two years. It was women within that age bracket who were buying them first using social media the most. I was saying to the organisation that I was working for at the time that we, as perinatal mental health, should be getting in that space where the women are. But it was a government organisation, bureaucracies are a little bit sluggish. They didn’t really want to act on that, so I left the organisation behind and just set it up representing myself as a nurse (not the organisation). But I put myself up on social media in that space. Initially, because I was still working in perinatal mental health, it had a focus around that. But the funding for that role disappeared, so my focus has become much broader since then.

MA: It certainly has grown, as has your following. You’ve got a lot of subscribers to your website and I get regular emails and information.

PM: Yes.

MA: If people want to subscribe they can just google meta4rn and they can become a subscriber to your site and get access to some of the great information on your blog?

PM: Yes, and look, only if you want to. It won’t be too spamy, I tend to write about one blog post a month now. So, you can do that. If you don’t want to subscribe, if you’re like me you’re probably sick to death of too many emails. Just have a look around and see if there’s anything of interest for you.

MA: Navigate it via the website?

PM: Yes.

MA: You’re an excellent speaker about the importance of nurses and midwives blogging, or being active on social media. Indeed, Paul and I are at the 45th International Mental Health Nurses Conference in Sydney. We have been here since the beginning of this week. We’re recording this podcast on the 10th of October which many of you will know is World Mental Health Day. So, happy World Mental Health Day to you all! May you commit to your own mental health self-care and support. Paul, I think that’s vital. You gave a great session yesterday about nurses and social media. Could you talk a bit more about that please?

PM: The session was 45 minutes long so I definitely won’t give you that much information. But look, the short story is that we (as nurses and midwives) now have access to telling our stories and more access to the public conversation than what we have ever had before. I used some data to back this up, so it’s not just a dopey opinion. But I think maybe if we went back 10 years in time it would be frustrating to hear mainstream media talking about nursing issues without actually talking to any nurses. That still happens now, of course. But, from my point of view, I think that rather than getting frustrated about the mainstream media why don’t we take control of what we do have? This is things like social media; Twitter, blogs in particular, YouTube, Facebook. Make it separate from your personal accounts. I find Instagram a little bit harder to use in a professional sense, but I’m playing with it. I’m probably the wrong demographic to really be good at Instagram. All of these social media platforms are free to access and give us the opportunity to get our voice out there and join in on those conversations. People get to hear from us now, whether they want to or not. I think that’s a really important power. I think that we’d be foolish to ignore it.

I’m not suggesting for a moment that each and every nurse, midwife or student listening to this podcast should go out and create a social media portfolio. That’s not going to be everybody’s cup of tea. But there were some people who were wondering about it, and I would encourage you to explore that space. Nurse Uncut, the NSW Australian Nurse and Midwifery Foundation companion website, they’ve got a blog role there that includes some great examples of nurses and midwives who have got blogs out there. Some of them are really really good, many of them are much better than mine in terms of the way that they look and the clarity of information that they present. But I think that if you’re thinking of having a go, have a go. My only suggestion or caution around that, as a mental health nurse so of course we’re big on boundaries, if you are going to go and do that be really intentional about setting up a professional social media portfolio quite separate to your personal stuff. So, my holiday snaps and what have you, to show off to family and friends are not under my own name. You wouldn’t be able to stumble across them easily, but if you were to Google Paul McNamara mental health nurse or Paul McNamara Cairns you will get bombarded with stuff that I want you to see. I’m mindful that some of my patients, colleagues and bosses will search for me on Google. Usually not with sinister intent, but more out of curiosity. I want to be in charge of what they see, and that’s what that’s all about.

MA: Thanks Paul, I think that’s really useful information. It’s a bit outside of our key or core topic today but it’s still some very useful information for nurses and midwives. Also, I would add that there’s some very useful information on using social media and blogging effectively. But also, in relation to your regulatory requirements on the Nursing and Midwifery Board of Australia website. So, if you’re kind of worried about how you’re presenting yourself, check those out first to make sure that you’re considering the regulatory requirements of your registration.

PM: And, look, I feel like those are fairly common sense guidelines. The short version is: don’t be a dick, and you’ll be fine.

MA: Good point Paul. Paul, you and I have been speaking about suicide and our concern for the profession, for nurses and midwives in relation to this since we first spoke at the beginning of Nurse & Midwife Support in 2017. In fact, you contacted me and raised your concern in relation to this issue. Indeed, the effect that the suicide of several colleagues at your health service had on you and other members of the team. Would you please share with our listeners why you think this issue is important for us to discuss? In relation to nurses and midwives? Indeed, getting it out into the open.

PM: I was really thrilled when Nurse & Midwife Support launched. I don’t know whether it’s a coincidence that that launch in March 2017 coincided with that paper I was talking about, which was published in November 2016. It was probably too short a lead time to have caused an effect, but the timing was great anyway. The advantage that Nurse & Midwife Support have over the Employee Assistance Programs or going off to see your GP is that it’s specifically targeted to nurses and midwives. It’s 24 hours a day, 7 days a week, which reflects the shift working nature of our jobs. For many and probably most of us anyway. Having that great degree of flexibility is really important.

A downside is probably that it’s all phone based. For a lot of us, at a time of emotional distress we’d really appreciate that face to face contact. But this is a good first step and I’m really pleased that it’s there. I’m the mental health guy who wanders around the general hospital, and I hear mixed reports about peoples experience with the Employee Assistance Program. Some people have had a terrific service, but not all. Particularly, if people are carrying concerns that they think may jeopardize their employment or their registration, accessing support via your workplace is scary. Being able to go beyond the workplace, far far away down to the other end of the telephone has that advantage around that. So, if the way that you manage your stress is that you’re really hitting the booze or doing something that might get you judged poorly in your workplace, I think it’s a great advantage to have somebody far away from the workplace that you can have that conversation with. So, if you do need to go back to your workplace and discuss that part of the issue, you may be able to go back with an at least partially formed solution. I think that that’s the great advantage.

MA: Thanks Paul. Just to clarify for our listeners, Nurse & Midwife Support provides brief intervention counselling and referral pathways. If you phone our service and you need face to face counselling, as Paul suggests, then we’re able to give you some referral options so that you can access that service. But I think in the first instance, it’s often really useful to phone a service like Nurse &Midwife Support, talk through the issue and get some options in terms of where you may go next. Paul, you state in your blog that suicide is a complex matter, that does not lend itself to easy understanding or simple solutions. However, something we know about health professionals is that they know that there are mental health services and supports. Health professionals know that these services can be accessed by people who are feeling suicidal. The data that you cite, and the research suggests that health professionals have an actual or perceived barrier to accessing these existing supports. You posed the question, I wonder what that barrier is? Paul, what is the barrier?

PM: I need to really clarify that I don’t know, that’s probably something for another team of researchers to explore. I can’t pretend that I know for sure but I imagine, through conversations with colleagues, that one of the barriers is about embarrassment. Shame. Nurses and midwives tend to be empathetic creatures, but because we’re so immersed in other people’s traumas we sometimes put up barriers which sometimes include some really irreverent defences. Like, if someone comes in after a suicide attempt, I have heard people say, “Why don’t they do it the proper way?” Stuff like that. When we say stuff like that, in front of each other, it doesn’t really give us permission to disclose that we’re at that point or getting close to being at that point. So, I think that sometimes the defences that we use so that we can go back to our job from day to day may accidentally stigmatize accessing support for each other. That’s what I was really trying to argue in that blog post. That we should just be a little bit careful about the ways in which we talk about suicide, for our patients and/or vulnerable colleagues. Let’s reach out to our colleagues, give permission and actually encourage them to come out and say that it’s ok to put up your hand if you’re going through a really rough spot. It would be foolish to pretend that that alone would make a big difference, but it would help.

MA: Thanks Paul. Do you think that there is a specific stressor, or there are stressors that prompt nurses to commit suicide rather than seeking help?

PM: Again, I’ll throw in the disclaimer that I won’t pretend to have all of the answers. But think about us, as nurses and midwives, and think about our psychopathology. We’ve probably got more empathy than the general man in the street. We’ve been attracted to do a job which almost in essence means that we’ve got to put the needs of others before our own needs. Anyone whose held their bladder for an 8-hour shift would recognise that. While you’re running around putting in catheters for other people, it’s not unusual for us to put the needs of others before us. I wonder whether that’s a part of the reason that nurses and midwives are overrepresented in suicide data, we’re not good at putting ourselves and our own needs first. Throw in on top of that, many of us do shift work so being sleep deprived makes us more emotionally vulnerable. We get exposed to other peoples’ trauma face to face. We’re up close and personal with our patients physical and emotional traumas. We’re the people who go behind the curtain and get exposed to those really raw emotions. For us to pretend that that’s not going to have a knock-on effect, would be a little bit foolish.

MA: Thanks Paul. On this day, World Mental Health Day, the 10th of October, we obviously place the spotlight on mental health. Do you think that there’s a lot of untreated mental health amongst nurses and midwives? Or indeed, untreated mental illnesses amongst nurses and midwives?

PM: Yes, we’re overrepresented in those common mental health problems such as depression and anxiety. We’re more likely than our patients to experience depression and anxiety, and I’m guessing for some of those reasons that I was just talking about before. There is, yes.

MA: Do you think that a more widely utilised facility for clinical supervision for nurses and midwives would improve their mental health and wellbeing?

PM: It’s about the only thing that stopped me from going mad. I probably am still a bit mad, but my clinical supervision has been such an important part of my practice. In Queensland, anyway, clinical supervision has been available to any mental health nurse working in the public sector since 2009. Interestingly, in the guidelines before that which were implemented in 2003 in Queensland, nurses were explicitly excluded from it. The rationale for that was a really good one, which is that it would cost a lot of money. But, it’s really important. We do emotional labour. We need to make sure that we look after ourselves.

Clinical supervision, just for those who don’t know a whole lot about it, it’s a bit of a dopey name. The analogy I use is say, a lot of our listeners will hold a Bachelor of Nursing or a Bachelor of Midwifery. Some of our listeners may hold a masters in this space, but not many of us will actually be bachelors or be masters. So, the name doesn’t necessarily accurately reflect what’s going on now. Clinical supervision was named about 100 years ago by psychotherapists. They were addressing their patients, one on one, who were talking through their problems. If they didn’t feel 100% confident that they weren’t making mistakes with the way that their sessions were progressing, they could tap a trusted colleague on the shoulder and be able to discuss the case with them. The colleague was then able to give supervision and support, to minimize the risk of harm to the patient.

That’s where the name comes from, it’s a bit icky for nurses and midwives. We’ve come from a fairly bullying culture so the idea of supervision sounds like scrutiny. It’s not. It’s very much about support and I was really thrilled to see in April this year that the College of Nurses, the College of Midwives and College of Mental Health Nurses in Australia put out that joint statement saying that Clinical Supervision should be available to all nurses and midwives, not just mental health nurses. All nurses and midwives in Australia should be given that opportunity to reflect on their practice so they can care for themselves. It’s not a self-indulgent thing, as this will enable them to provide better care for their patients.

MA: Thanks Paul. Just to pick up that point you made, because I do hear this when I’m around the traps talking to nurses and midwives around the bullying culture in nursing. I know some of our listeners will be very interested in this.

PM: I’ll be fair dinkum with you about this Mark. I think as a bloke, I kind of have managed to stand apart from that. It’s a bit weird, we’ve got two men here talking about nursing and midwifery. I think 89% of general nurses are female and 99% of midwives are female. So, it’s weird that blokes are talking about this, and I think that as a man I’ve probably dodged most bullets around bullying. But I hear it from my colleagues. A lot of it isn’t necessarily intentional. It’s about what happens in our workplace, we’ve got this busy stuff going on in busy wards that are crisis driven. There’s always a crisis going on. When something that would normally be addressed with empathy, kindness and calmness. Being met with an invitation for tea in the staff room, I think nursing has a culture where it’s like, “I can see you’re upset, but let’s get on with it.” I think that that emotional neglect is probably the biggest source of bullying that I’m aware of. But I know that through my gender, I’ve got blind spots around bullying.

MA: Thanks Paul, and what are you doing to look after your own mental health? A part from clinical supervision?

PM: Well clinical supervision is number one. My wife Stella is also a nurse, so we speak the same sort of language. We kind of look after each other. We’re really good at going to restaurants and going on holidays. We make a point of doing those sorts of things, to give ourselves treats. We’re working to get a benefit out of our nursing work. A personal benefit. More recently, I’ve recommitted myself to being a bad tennis player and an awful guitar player. Bought myself a new tennis racket and a new guitar, and I’m determined to be a little less crap at both.

MA: Well I look forward to seeing you in a band soon Paul. Just one last question, do you have a cut through message that will support nurses and midwives to seek help? Who may be at risk of suicide?

PM: Yes, don’t leave it until it’s too late. I think we’re almost predisposed to go; “Oh she’ll be right, she’ll be right, she’ll be right.” Don’t leave it until it’s crisis point would be my idea. If you’re going through a bit of a rough patch, don’t be shy about picking up the phone to Nurse a& Midwife Support. If you’ve got a decent GP who you can have a yarn to, that would be the next best port of call. He or she can make a referral to a credited mental health professional such as myself or maybe a psychologist or someone who can provide that one on one emotional kind of support. Just prioritise your health. I’m playing a tricky little emotional blackmail on your listeners now, but even if you don’t want to do it for yourself, it would be really good for your patients if you’re not overwhelmed by depression and anxiety. If you’re a bit motivated by helping others, you can do that by helping yourself.

MA: Thanks Paul, great advice. Well I can’t believe we’ve come to the end of another podcast, we could talk about this all day! Thanks Paul, we’ve had some great conversations since we met in 2017. We’ve talked about Nurse &Midwife Support today; mental health, suicide and the barriers for nurses and midwives accessing support. We’ve talked about stigma, the research, we’ve provided some strategies for overcoming stigma and the elements to supporting nurses and midwives at risk of developing mental illness and suicide. Paul, do you have any final words of wisdom for our listeners?

PM: Wisdom? No. But look, good luck out there. We know it’s a difficult job. You deserve to be cared for.

MA: Thanks Paul. If you found this podcast useful, please share it with other nurses, midwives, graduates and students. Feel free to rate us on whatever platform you’re listening on. That will help to elevate us and for other people to actually find our podcasts. This is important, because your health matters. Look after yourselves and each other, we’ll have some information attached to this podcast that will provide you with access to Paul’s blog, his website and indeed some services that can support your health and wellbeing. Take care, and I’ll speak to you next time.

 

Three Links

The podcast and transcripts:
www.nmsupport.org.au/resources/podcasts/discussing-suicide-jon-tyler-paul-mcnamara

Suicide info:
www.nmsupport.org.au/mental-health/suicide

Nurses, midwives, medical practitioners, suicide and stigma
www.nmsupport.org.au/news/nurses-midwives-medical-practitioners-suicide-and-stigma

End

That’s it. Thanks again to Nurse & Midwifery Support – what a terrific back-up for me and my colleagues.

As always, your feedback is welcomed via the comments section below.

Paul McNamara, 10 September 2020

Short URL: meta4RN.com/podcast

 

Are there smartphone apps specifically for people who experience eating disorders?

Q: Are there smartphone apps specifically for people who experience eating disorders?
A: Yes. Three*
1. Rise Up + Recover www.recoverywarriors.com/app
2. Recovery Record – RR www.recoveryrecord.com
3. MindShift www.anxietycanada.com/resources/mindshift-cbt

Q: Is this the shortest blog post in the history of humans?
A: No. Please read on for elaboration, geeky stuff and a disclaimer (look for the red asterisk* below).

Elaboration

Recently I was chatting with someone who experiences an eating disorder and was asked whether there were any apps specific to their circumstances. I was a bit busy at work, and only had time to to check-out Australia’s digital mental health hub Head To Health, and found nothing specific to eating disorders there. A few things pop-up on a google search, but when you’re a health professional you need to be careful about prescribing digital technologies. As articulated in editorials, letters, journal articles and blogs, health professionals have a responsibility to do no harm, and provide credible, evidence-based information if giving advice re apps, websites or other digital technologies.

Geeky Stuff

Fairburn and Rothwell (2015, p. 1038) took a systematic approach to clinical appraisal of eating disorder apps, and concluded, “The enthusiasm for apps outstrips the evidence supporting their use.” Ouch.

But that was way back in 2015, some people are still giving eating-disorder-specific app development a go, and digital therapeutics evolve quickly, so I thought it was worth doing a search of credible sources anyway.

After searching Head To Health, later (in my own time boss) I had a look at the Queensland Eating Disorder Service (QuEDS) resource page, the Butterfly Foundation website, and the Eating Disorders Victoria site and couldn’t find recommendations for apps. I then signed-up for ORCHA (“the world’s leading health app evaluation and advisor organisation“) and did a search there – that yielded poor results. Searching ORCHA for “eating disorder” was too broad and yielded a list of food/diet-related apps. Searching ORCHA for “anorexia nervosa” yielded two apps that had a green rating – one was a NHS/UK-only app, and when I clicked the other one on the App Store the top review spoke about their weight-loss. It might be a good app, but I’m afraid to share it here. That sort of thing would probably be laughed-off with an eye roll by someone who is living with an eating disorder and is in a good head space, but could really throw a spanner in the works for someone who isn’t in a good head space. The mortality rate of eating disorders is a worry, so primum non nocere.

Then I stumbled into the Centre for Eating and Dieting Disorder (CEDD) website and found a resource called “Navigating Your Way to Health” and, lo and behold, found this on page 33:

Using apps can be a handy way of helping you in your journey to recovery. We’ve listed some FREE apps here that might be useful. The following apps have been designed to help people with eating disorders to empower you to be in control of your recovery.
> Rise Up + Recover 
> Recovery Record – RR 
> recoveryBox 
> MindShift 

Disclaimer*

Although it was listed in the resource above, I left the recoveryBox app off my list at the top of the page because as at 09/08/20 (today) their website isn’t working. The app is still available on the App Store, but as the website is out of action, I’m guessing the app isn’t being updated any more. “Navigating Your Way To Health” was published in 2016 and, as noted above, digital therapeutics evolve quickly. It seems they devolve quickly too.

I’m pretty confident this is credible information as of right now, but who knows what reviews are underway or what apps are in development? Not me. For all I know there will be a fantastic Australian app co-produced by consumers/survivors, clinicians and academics tomorrow. I hope so. Just in case, check in on CEDD if you’re reading this after 09/08/20.

As noted in my recent blog post regarding the stepped care model (“One. Step. Beyond.” meta4RN.com/step) the concept of “one size fits all” doesn’t apply in mental health recovery. On the same theme, apps can be a useful addition to other strategies and useful for maintenance/relapse prevention. They should not be relied on alone if someone is experiencing significant symptoms of poor health.

I won’t pretend for a moment to have any special insight into what is a useful app for people who are experiencing an eating disorder, and don’t really have the time, skill-set or funding to undertake an independent review. I do trust the credibility of CEDD though, and if they say these apps are OK, who am I to say otherwise?

As originally noted in September 2012 (see number 13 here: meta4RN.com/about), the views and opinions I express here or on related social media portals do not represent the views of my employer. That really should be taken for granted, but anyway…

One last thing in this section: I don’t have any financial/other ties to any of the organisations or apps named above.

References

Daya, I., Hamilton, B. and Roper, C. (2020), Authentic engagement: A conceptual model for welcoming diverse and challenging consumer and survivor views in mental health research, policy, and practice. International Journal of Mental Health Nursing, 29(2): 299-31.
doi: 10.1111/inm.12653

Fairburn, C.G. and Rothwell, E.R. (2015) Apps and eating disorders: A systematic clinical appraisal. International Journal of Eating Disorders, 48: 1038-1046.
doi: 10.1002/eat.22398

Ferguson, C., Hickman, L., Wright, R., Davidson, P. & Jackson, D. (2018) Preparing nurses to be prescribers of digital therapeutics, Contemporary Nurse, 54(4-5): 345-349.
doi: 10.1080/10376178.2018.1486943

Hunter Institute of Mental Health and the Centre for Eating and Dieting Disorders (2016). Navigating Your Way to Health: A brief guide to approaching the challenges, treatments and pathways to recovery from an eating disorder. NSW Ministry of Health.
via cedd.org.au/begin-recovery 

Neumayr, C, Voderholzer, U, Tregarthen, J, Schlegl, S. (2019) Improving aftercare with technology for anorexia nervosa after intensive inpatient treatment: A pilot randomized controlled trial with a therapist‐guided smartphone app. International Journal of Eating Disorders, 52: 1191– 1201
doi: 10.1002/eat.23152

Søgaard Neilsen, A. & Wilson, R.L. (2019) Combining e‐mental health intervention development with human computer interaction (HCI) design to enhance technology‐facilitated recovery for people with depression and/or anxiety conditions: An integrative literature review. International Journal of Mental Health Nursing, 28(1): 22-39.
doi: 10.1111/inm.12527

Wilson, R.L. (2018) The right way for nurses to prescribe, administer and critique digital therapies, Contemporary Nurse, 54(4-5): 543-545.
doi: 10.1080/10376178.2018.1507679

End

That’s it. Thanks for reading down this far 🙂

As always, you’re welcome to leave feedback in the comments section below.

Paul McNamara, 9 August 2020

Short URL meta4RN.com/app

 

Liaison in the Time of #COVID19

.

This page is an accompaniment to a brief presentation at the Inaugural ACMHN Consultation Liaison Special Interest Group online webinar via zoom – it is just a place to plonk things that I’ll talk about in case anyone wants to clarify anything for themselves.

So, here goes:

As noted on a previous blog post, Queensland’s population is much bigger than Australia’s smaller states/territories, but falls a long way short of Australia’s two largest states. 

 

Queensland’s population size compares better to New Zealand, Ireland, Norway and Singapore than other Australian states and territories.

 

All the data below is true as of 1 August 2020 (as you probably know, 1st of August = the Horses Birthday in Australia).

 

It is interesting to compare the number of Covid-19 cases across similar-sized populations. Obviously there are many differences between the populations too – not the least of which is land area – so I’m doubtful that a proper epidemiologist or public health professional would put much stock in this comparison. That disclaimer aside, it is noted that Queensland has a larger population than New Zealand – which is held-up as a shining-light of Covid-19 control – but, to date, has a lower incidence of Covid-19 positive people.

 

I’m not sharing the data about number of Covid-19 deaths as a macabre version of State of Origin or the Bledisloe Cup. It’s not a competition. It’s certainly not a game. Thousands of families across the world are in mourning. That said, isn’t it interesting how low Singapore’s death rate is compared to that of Ireland and, to a lesser extent, Norway? Both New Zealand and Queensland have been very fortunate to date in limiting the number of deaths.

 

Comparing the number of new cases of Covid-19 in the last 24 hours (as at 01/08/20) is also interesting.

 

Links to Data Sources
New Zealand
Ireland
Queensland
Norway
Singapore 

 

In the session there will be mention of the “Clean Hands. Clear Head.” strategy to embed anxiety-management into everyday clinical practice. More info about his via the blog post and video of the same name: meta4RN.com/head

 

Also in the session there will mention of “Positive Practice Environment (the other PPE)” Again, there is more info about this via a blog of the same name: meta4RN.com/PPE

 

Finally, here is a link to the Prezi that was used to make the video. My understanding is that all these pretty Prezis will stop working at the end of 2020 when everyone stops using flash (just letting you know in case you’re looking at this page in 2021).

 

In Support of our Victorian Colleagues

 

End

That’s it. I hope some of this info is of interest. As always, you’re welcome to leave feedback via the comments section below.

Paul McNamara, 3 August 2020

Short URL: meta4RN.com/zoom