Education in new consumer-centred mental health and addiction treatment aims to increase graduate uptake

However, not enough new graduates are choosing mental health nursing as a career. The Bachelor of Nursing programme at Toi Ohomai Institute of Technology in the Bay of Plenty is working with a local district health board to change this with the support of Toi Ohomai’s research coordinator, Dr Judith Honeyfield.

The mental health and addictions team at Lakes DHB implemented a new consumer-centred model called Feedback Informed Treatment (FIT) in 2018. It is a collective approach that is particularly responsive to Māori. This is important in a region where 72% of people accessing mental health and addiction services are Māori.

‘FIT is a unique model. It allows mental health consumers – tangata whai ora – to be at the centre of treatment from the beginning, ensuring their feedback is taken into account, which impacts the way in which goals are set and how whānau is involved,’ co-researcher, Joanna Price, Director of Nursing for Mental Health at Lakes DHB explains.

The team’s research aims to analyse factors that were expected to improve mental health nursing practice development in the context of FIT. To this end, Toi Ohomai upskilled all 38 third-year nursing students in FIT this year and undertook an evaluative piece of research on those that went on to use the model at Lakes DHB as part of their final 12-week transition placement.

A large group of people were involved in the project, including the Toi Ohomai students, clinical nurse educators (preceptors), academic staff who teach the mental health and addiction component, as well as senior management staff at Lakes DHB. The preceptors were able to role model FIT for the students.

Initially it was thought that all six students with mental health and addiction placements would take part in the research. However, it became apparent that although the community health team were able to use some of the FIT theory it was too difficult to use in its entirety. Ultimately, the two students who undertook acute placements in the Lakes DHB mental health team and four preceptors took part in the study.

Data were collected from these participants in two focus groups, once at the start and once at the end of their placement. Study results demonstrated that academic training in FIT enhanced the student experience and therefore should be continued.

The data showed that by providing expertise in FIT before the placement, the students reported that they could more actively participate in their placements at Lakes DHB rather than feel side-lined in a spectator role. The research demonstrated that they understood the model and could positively engage with tangata whai ora. 

'They had learnt the importance of involving whānau, of being open to constructive criticism, and the concept of consumer-centred care. They developed an early bond with the patients which continued through to discharge. They understood the team approach, and that sometimes a different member of the team should be the primary provider,' explains Honeyfield.

This learning all contributed towards a more positive practice experience and the students described feeling positive towards their placement, which isn’t always the traditional experience of students new to mental health and addiction services.

A reoccurring theme throughout the conversations in the project was ‘come do this with me.’ It was a phrase consistently used by students, tangata whai ora, and registered nurses alike.

‘It was quite magic really – it was holistic and family-centred, built on a culture of partnership and feedback, and focussed on improving nursing practices – all of a sudden it seems quite sensible to ask people for feedback, but really it is quite revolutionary,’ says Honeyfield.

Their research shows that education and practice partnerships are a powerful change process in the work to achieve this shift.

New graduate choices from this and next years’ cohorts will determine if the overall strategy of increased exposure to positive mental health and addiction treatment processes is effective in increasing numbers selecting it as a career choice.

• Dr Judith Honeyfield is a Research Coordinator, Faculty of Health, Education and Environment Research Office at Toi Ohomai Institute of Technology. She is also a Principal Academic Staff Member in the Bachelor of Nursing. She has worked on numerous Ako Aotearoa research projects at both national and regional levels and is an experienced research team leader and teaching workshop facilitator. Email Judith Honeyfield.
  
  
• Dr Judith Honeyfield worked with colleagues Joanna Price, Director of Nursing for Mental Health, Lakes DHB and Stephen Ward, Senior Mental Health Nurse Educator, Toi Ohomai Institute of Technology.
  
  
• Visit Toi Ohomai's website.