Val Goodwin

Focus groups are a popular component of nursing research. While they have their advantages, a number of disadvantages are apparent, such as the difficulty involved in capturing individual responses. The use of a tracking sheet would allow the researcher to identify individual responses, and thus produce separate transcripts for each participant, which can be forwarded for verification or discussion. The advantage of this approach is that the researcher is able to obtain an account from individuals in addition to the group account.

Australian government policy has effectively mandated consumer and carer participation. However, the limited relevant literature suggests there are significant barriers to implementing participation in mental health services. Nurses have been identified as a professional group with an important role in creating the culture changes necessary for successful implementation, yet their views about consumer and carer participation have not been extensively explored. This article presents Part 2 of the findings of a qualitative study using focus group interviews with 30 nurses to explore opinions on the topic of consumer and carer participation. Data were analyzed using a content analysis approach, assisted by the software package NVivo. The themes explicated were systemic barriers and education, an essential ingredient. These findings emphasize the barriers and provide some sense of how educational techniques might assist with making some constructive inroads.

Consumer and carer participation in mental health delivery is now enshrined in Australian Government policy. However, strategies assisting in implementing this vision have not been explored. Nurses are crucial to the mental health workforce, both in numbers and by virtue of the therapeutic relationship. The willingness of nurses to encourage consumer and carer participation is therefore essential for implementation of this policy. This article presents part 1 of the findings of a qualitative study exploring nurses' opinions regarding consumer and carer participation. Data were analyzed using a content-analysis approach, assisted by the software package NVivo. The themes explicated were as follows: Consumer and carer participation—a help or a hindrance? Encouragement—an important role for nurses; and communication—a gift of nursing. These findings highlight the unique and important role nurses can play in encouraging participation and explore some of the issues involved if that role is to become a reality.

Australian mental health policy now clearly articulates that consumer and carer (informal caregiver) participation in all aspects of service delivery is an expectation. As the largest professional group, nurses clearly play a key role in translating policy into practice. The aim of this article is to briefly overview the history of mental health service development in Victoria, with specific emphasis on the development of psychiatric nursing. Changing perspectives of consumers of mental health services and their informal carers is discussed. Policy development is described in the context of the development of mental health services. It is argued that an appreciation of the history of punishment and confinement is necessary for providing a climate conducive to consumer and carer participation.

Family members and significant others provide significant proportions of unpaid care for people experiencing a mental illness. Although the carer role is pivotal to contemporary mental health service delivery, the role of carers and the issues they face have received only scant attention in the literature. This paper presents the second part of the findings of an exploratory, qualitative inquiry, which sought greater understanding of carers' experiences of, and attitudes to opportunities for participation in care and treatment at an individual or systemic level, with particular emphasis on the role of psychiatric nurses in encouraging or discouraging participation. This paper explores the theme of systemic barriers to participation. These findings demonstrate the variable experiences of carers in their opportunities to participate and the important role nurses can assume in supporting carers' increased participation in the mental health care for their relative or significant other.

The role of family carers in the delivery of mental health services in Australia has become more than an advantage over not having this sort of participation. Increasingly the involvement of non-paid carers (family members and significant others) has been recognised as central to the smooth delivery of care and treatment. Notwithstanding this acknowledgment, there is very little discussion of carer participation in mental health care delivery within the literature. The limited research in this area suggests that carers recognize very little opportunity for genuine participation, even less than is available to consumers. This paper presents part 1 of the findings of an exploratory, qualitative study seeking an in-depth understanding of the attitudes of carers from rural Victoria, Australia toward opportunities for participation with specific emphasis on the role of psychiatric nurses in encouraging or discouraging participation. The themes of respect and communication will be described in this paper. These findings demonstrate the variable experiences of carers in their opportunities to participate and the important role nurses can assume in supporting both carers and consumers through this process.

ABSTRACT:  Increasingly, Australian government policy advances an expectation that consumer and carer participation will be present in all aspects of mental health service delivery. A review of the literature suggests that consumers and carers actively seek the opportunity to participate but are frequently hampered by barriers. However, government policy documents tend to discuss consumers and carers with regards to participation as though their needs and desires are essentially similar. This paper presents the findings of a qualitative research project involving in‐depth interviews with carers and mental health nurses. The issue of conflict between the issues for consumers and carers emerged as a major theme. This issue is explored and discussed in light of the goals of current mental health policy. It is concluded that conflicting agendas are apparent and must be addressed if genuine participation in service delivery is possible for both consumers and carers.

The opportunity for consumers to participate in all stages of mental health service delivery, including the planning of their individual care, is now clearly enshrined in Australian mental health policy. Published research which examines the extent to which this has been realised in practice is limited, and the paucity is even greater for research reflecting the views of the consumers themselves. This paper presents the findings of a qualitative study. In-depth interviews were undertaken with consumers of mental health services from two rural areas in Victoria to explore their views and opinions regarding their ability for genuine participation in the planning and delivery of their mental health care, and in particular on the role of nurses in facilitating this process. Data were analysed with the assistance of NVivo, using a content analysis approach. The main themes identified were: respect, encouragement, collaboration and systemic barriers. The findings suggest that consumer participants identify a number of barriers which limit their ability to participate effectively. The implications for the role of the nurse in facilitating genuine consumer participation are discussed.

Preceptorship is a valuable strategy largely underestimated in its ability to influence nursing students’ attitudes and beliefs about mental health nursing. As a model, it has the potential to influence nursing practice, enhance clinical learning, promote recruitment and retention, and generate a more collaborative approach for nursing student supervision. The relationship is usually for a fixed and limited timeframe where the preceptor inspires and supports the growth and development of the student nurse, and encourages role socialization into the profession (Morton-Cooper & Palmer 2000). The challenge for mental health services is to achieve success in the provision of effective preceptorship, ensure positive and rewarding clinical experiences for nursing students, and improve recruitment and retention rates for the service. These aims are substantially more difficult to achieve in the absence of quality education, training and support for preceptors. This paper describes the use of preceptorship training to address recruitment issues in a rural service, particularly the need for effective preceptorship at undergraduate level, which has been shown to have an impact on the willingness of new nursing graduates to enter the mental health nursing field. The design and delivery of the training programme is outlined, including details of the program evaluation and its subsequent impact on psychiatric nurses’ approach to and practice of preceptorship. Finally, the broader issue of the value of training nurses in larger groups, enlisting a critical mass of preceptors within an individual mental health service, is discussed