Mental health nursing standards and practice indicators for Australia: a review of current literature

There are many changes and challenges facing the mental health care professional working in Australia in the 21st Century. Given the significance of their number and the considerable extent to which care is delivered by them, mental health nurses in particular must be at the forefront of the movement to enhance and improve mental health care. Mental health nurses in Australia must not only keep up with the changes, we should be setting the pace for others across the profession worldwide. The increasingly complex field of mental health nursing demands nurses who are not only equipped to face the challenges but are confident in doing so. Definitive guidelines for practice, clear expectations regarding outcomes and specific means by which to evaluate both practice and outcomes are vital. Strengthening the role and vision of mental health nursing so that there is clarity about both and highlighting core values by which to perform will enable us to become focused on our future and what we can expect to both give to and receive from our chosen profession and how we can, and do, contribute to mental health care. The role of the mental health nurse is undergoing expansion and there are new hurdles to overcome along with the new benefits this brings. To support this, nationally adopted, formalised standards of practice and means by which to measure these, i.e., practice indicators formerly known as clinical indicators, are required. It is important to have national standards and practice indicators because of the variances in the provision of mental health across Australia – different legislation regarding mental health policies and processes, different nursing registration bodies and Nursing Councils, for example – which create additional barriers to cohesion and uniformity. Improvements in the practice of mental health nursing lead to benefits for consumer outcomes as well as the overall quality of mental health care available in Australia. The emphasis on rights-based care, particularly consumer and carer rights, demands evidence-based, up-to-date mental health care delivered by competent, capable professionals. Documented expectations for performance by nurses will provide all involved with yardsticks by which to evaluate outcomes. Flowing on from these benefits are advances in mental health care generally and enhancements to Australia’s reputation and position within the health care arena throughout the world. Currently, the ‘Standards for Practice’ published by the Australian New Zealand College of Mental Health Nurses (ANZCMHN) in 1995 and the practice indicators developed by Skews et al. (2000) provide a less formal guide for mental health nurses working in Australia. While these earlier standards and practice indicators have played some role in supporting mental health nurses they have not been nationally or enthusiastically adopted and there are a multitude of reasons for this. This report reviews the current literature available on practice indicators and standards for practice and describes an evidence-based rationale as to why a review and renewal of these is required and why it is important, not just for mental health nurses but to the field of mental health in general. The term ‘practice indicator’ is used, except where a quotation utilises ‘clinical indicator’, to more accurately reflect the broad spectrum of nursing roles, i.e. not all mental health nursing work involves a clinical role.

Women wearing peace aprons during Peace march in Brisbane, Australia 1963

Women wearing peace aprons during Peace march in Brisbane, Australia 1963. Cars can be seen in the background.

Marchers holding banner declaring For their sake fight for peace during the 1963 Peace March, Brisbane, Australia

Marchers holding banner during Peace march in Brisbane, Australia 1963. Tram and car can be seen in the background. Banner declares For their sake fight for peace, their future is in your hands.

Women and men during the 1963 Peace March, Brisbane, Australia

Women and men during Peace march in Brisbane, Australia 1963. Car can be seen in the background. Two men one with drum follow the women, one of which has a banner Women strike for peace say U.A.W. The Union of Australian Women is a national organisation that was formed in 1950. Its aim is to work for the status and wellbeing of women across the world. It has been involved in a wide variety of campaigns that concern women. The Union of Australian Women networks with other women's community and union groups on such issues.

Save our sons banner on float during May Day procession in Brisbane, Australia 1967

Save our sons banner on float during May Day procession in Brisbane, Australia 1967. Other signs on truck include No conscription and Death lottery 1967.

Onlookers on buildings during the Youth Campaign against Conscription, Brisbane, Australia

Onlookers on buildings during the Youth Campaign against Conscription, Brisbane, Australia on March 24 1966. Paddy wagons, police and a tram can be seen on the corner of Queen and Albert Streets Brisbane. Facade of T & G corner with Spiers Chemists, Mimi building and NM centre can be seen in the background.

Free Zarb banner in Mayday procession in Brisbane, Australia 1969

Free Zarb banner in Mayday procession in Brisbane, Australia 1969Truck has another banner Trades and Labor Council of Queensland and affiliated unions. Banner reads Free Zarb and other political prisoners - gaoled for refusing to kill, end conscription. Facade of KR Darling Downs building can be seen in the background.

Members of the Australian Labor Party during Mayday procession in Brisbane, Australia 1969

Members of the Australian Labor Party during Mayday procession in Brisbane, Australia 1969.

Marchers in Mayday procession in Brisbane, Australia 1969

Marchers in Mayday procession in Brisbane, Australia 1969. They hold flags and one has placard reading Give a guerilla gun, support revolution now.

WWF Peace Committee float during Mayday procession in Brisbane, Australia

WWF Peace Committee float during Mayday procession in Brisbane, Australia. Banners include Drop prices not bombs and World peace for a better life. Men women and children are aboard the truck, some in costume.

Mounted police during Mayday procession 1965 Brisbane Australia

Mounted police during Mayday procession 1965 Brisbane Australia.

Combined Railways Union float during Mayday procession 1965 Brisbane Australia

Combined Railways Union float during Mayday procession in 1965, Brisbane, Australia. Banners read Stop menacing hand of Vietnam War and 50,000 people used Beenleigh Southport line in 1963.

Using FCD Mapper Software and Landsat Images to Assess Forest Canopy Density in Landscapes in Australia and the Philippines

Using Landsat imagery, forest canopy density (FCD) estimated with the FCD Mapper®, was correlated with predominant height (PDH, measured as the average height of the tallest 50 trees per hectare) for 20 field plots measured in native forest at Noosa Heads, south-east Queensland, Australia. A corresponding image was used to calculate FCD in Leyte Island, the Philippines and was validated on the ground for accuracy. The FCD Mapper was produced for the International Tropical Timber Organisation and estimates FCD as an index of canopy density using reflectance characteristics of Landsat Enhanced Thematic (ETM) Mapper images. The FCD Mapper is a ‘semi-expert’ computer program which uses interactive screens to allow the operator to make decisions concerning the classification of land into bare soil, grass and forest. At Noosa, a positive strong nonlinear relationship (r2 = 0.86) was found between FCD and PDH for 15 field plots with variable PDH but complete canopy closure. An additional five field plots were measured in forest with a broken canopy and the software assessed these plots as having a much lower FCD than forest with canopy closure. FCD estimates for forest and agricultural land in the island of Leyte and subsequent field validation showed that at appropriate settings, the FCD Mapper differentiated between tropical rainforest and banana or coconut plantation. These findings suggest that in forests with a closed canopy this remote sensing technique has promise for forest inventory and productivity assessment. The findings also suggest that the software has promise for discriminating between native forest with a complete canopy and forest which has a broken canopy, such as coconut or banana plantation.