While mental health nurses (MHNs) have continued to provide clinical services within both in-patient and community settings throughout the pandemic, their specific skillset has been underutilised, when the impact on society’s collective mental health is considered.  

With nursing staff being diverted to undertake direct COVID-19 response roles, the services provided by MHNs have often been undertaken in the context of reduced staffing.

But Professor John Hurley, Vice President of the Australian College of Mental Health Nurses, says additional MHN roles have been significantly underutilised, despite the profession’s willingness to enact their unique skill set.

“MHNs and hence their consumers lack access to MBS funded services that are needed now, and into the future,” says Professor Hurley.

According to Professor Hurley, the pandemic has created a short-term urgent need for a specialist mental health workforce, as well as the need for longer term growth of mental health workforce volume, and capability.

“Prior to the pandemic the Australian mental health system was identified by both the Productivity Commission and the Victorian Royal Commission as not meeting the needs of the population, being fragmented and overly complex to navigate,” says Professor Hurley.

“Additionally, approximately a third of the population were too complex for primary MH services but not critical enough to receive tertiary services.

“COVID-19 has exacerbated this long-standing systemic issue to a critical point where need for mental health service exceeds the numerical capacity and the capability capacity to respond to increasing complexity of need.”

Young people have been particularly impacted, with the number of 12 to 17-year-olds presenting at emergency departments in NSW for self-harm or suicidal ideation 49 per cent higher than it was in 2019.

“The main issues here are that around 80 per cent of all mental health problems emerge in the 12- 25 age group.

“Pre pandemic, those with emerging mental health problems were more at risk of social isolation. This age group, particularly the younger end of it, have significant need for social connectivity to maintain wellbeing. The peer separation emergent from the pandemic has consequently significantly exacerbated these issues.”

Professor Hurley believes media traditionally highlights the roles of medicine and psychology with mental health nurses being largely unmentioned.

“This is despite MHNs being at least degree equivalent trained with many, if indeed not most having post graduate specialist MH qualifications.

“MHNs traditionally work with those with more complex need and are hence often not in the public eye. However increasingly MHNs are working as psychotherapists, in schools as counsellors and in primary MH settings.

“Their scope of practice is wide, and they are arguably the only profession who can offer talk based psychological therapy, medication-based interventions, respond to complex risk, and offer physical health assessment and treatments, all in one visit and often in the consumer’s home.”

But as demand for the mental health nurses provide increases, access remains limited, with more funding required, and more support needed to increase the number of qualified MHNs, says Professor Hurley.

“MHNs have less access to the MBS than other disciplines, many of whom have little specialist MH undergraduate education and training.

“The ACMHN advocates for a new funding stream within the Medical Benefits Schedule (MBS), in essence a revised iteration of the previous Mental Health Nurse Incentive Programme to be re-launched as the ‘MHN Access Programme’ (MAP). 

“MAP funding would be included in the MBS and be administered through the national network of PHNs specifically for: People who are experiencing severe and complex but non urgent mental health issues.

“MAP would operate as a block funding model to support longer intervention times including outreach.  The ACMHN also advocates for credentialed MHNs to be included in Better Access funding steams.”