Introduction

Mental health is defined by the World Health Organization as “a state of well-being in which an individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and is able to make a contribution to his or her community. In this positive sense, mental health is the foundation for individual well-being and the effective functioning of a community” (World Health Organization [WHO], 2010, para. 2).

The needs of people living with mental illness are not being adequately met by the Canadian health system. Far too many Canadians are turning up at our emergency departments or being hospitalized unnecessarily for health conditions that could and should be managed in the community. This is a function of insufficient system-wide capacity.

Worldwide, mental health problems are among the leading causes of disability (WHO, 2008). In Canada, repeat hospitalizations (11% of all people hospitalized for mental illness in 2008-2009 were readmitted more than twice within the same year) and 30-day readmission rates (11.4% in 2009-2010) for this segment of the population are high (Canadian Institute for Health Information, 2011), indications that mental health service needs are not being met in the community. Canada lacks a comprehensive and population-based approach to mental health – one that emphasizes community-based services and recovery-based approaches and acknowledges the pivotal role of consumers and front-line providers in implementing system change.

Registered nurses (RN) working in all practice settings and along every point across the continuum care for people with varying degrees of mental health and illness every day:

• Public health and primary care nurses assess and screen new mothers for post-partum depression.

• Nurses working in emergency departments respond to patients experiencing acute psychotic episodes.

• Primary care nurses screen for and provide education around substance use and abuse.

• Street health nurses care for people who may be homeless and/or engaging in high-risk behaviours, in part because of an unmanaged mental illness.

• School nurses assess children and youth for the presence of eating disorders, bullying and abuse.

• Critical care nurses care for families experiencing grief, loss and shock.

• Medical/surgical nurses care for patients experiencing acute delirium, depression and anxiety.

• Psychiatric/mental health nurses often care for individuals who are at risk for self-harm or experiencing suicidal ideation.

• Nurses working in First Nation communities deal with intergenerational effects of trauma and abuse.

As holistic practitioners and care providers, we utilize our knowledge, expertise and therapeutic interactions to care for the mental health and well-being of individuals, communities and populations. Our numbers, our distribution and our role as knowledge professionals means that we are well-positioned to provide the leadership and solutions necessary to drive improvements in mental health service delivery.

References

Canadian Institute for Health Information. (2011). Health indicators 2011 . Ottawa: Author. Retrieved from http://secure.cihi.ca/cihiweb/products/health_indicators_2011_en.pdf  

World Health Organization. (2008). The global burden of disease: 2004 update. Geneva: Author. Retrieved from http://www.who.int/healthinfo/global_burden_disease/GBD_report_2004update_full.pdf  

World Health Organization. (2010). Mental health: Strengthening our response [Fact sheet N220]. Geneva: Author. Retrieved from http://www.who.int/mediacentre/factsheets/fs220/en