1. Consumers shaping mental health nursing education: Findings from the CoMMUNE project.
Brenda Happell, Professor
School of Nursing and Midwifery

2. Coproduced Mental Health Nursing Education Project is an international collaboration for development and implementation of EBE co-produced curricula supporting policy-endorsed and recovery-focused mental health care in nursing including an evaluation of its impact.

4. Research Methods Nursing student focus groups
pre and post test:
Mental Health Nurse Education Survey
Consumer Participation Survey
Opening Minds Survey
Nursing student focus groups
Interviews with Experts by Experience
Data collected from all partners except Iceland, only Australia, Finland and Ireland had sufficient post-test data to enable statistical significance to be measured
COMMUNE

5. Student Attitudes about Mental Illness & Mental Health Nursing
Australia (n = 70)
Increase:
Preparedness
Decrease:
Social Distancing
Other attitude domains: moved in directions aimed for, though not statistically significant
Attitudes to MHN: Preparedness for mental health field (PREPAREDNESS) and view that MHN makes a valuable contribution to consumer recovery
Attitudes to people with mental illness: negative stereotypes (e.g. unpredictable, dangerous; from NES) and social distancing (from OMS) avoiding or excluding people with mental illness.
Trend-wise, all attitudes changed in the direction desired. Of these, the statistically significant ones were improvement in preparedness and a drop in social distancing.

6. Australia (n = 70) Student Attitudes to Consumer Participation
Increase: Consumer involvement
Other attitude domains, not statistically significant
Sufficiency of services: this scale is about the view that usual services do well enough on their own (i.e. without the input or participation of consumers)
Attitude to consumer involvement in MH services were high at pre-test. Still a statistically significant improvement at post.
Of the other domains, trends went in intended direction for: lack of capacity (down), consumer academic (up), consumer as staff (up)

7. Student Attitudes about Mental Illness & Mental Health Nursing
Ireland (n = 59)
Increase:
Preparedness
Decrease:
Negative stereotypes
Other attitude domains: moved in directions aimed for, though not statistically significant
Trend-wise, all attitudes changed in the direction desired.
Of these, the statistically significant ones were improvement in preparedness and a drop in negative stereotypes.

8. Ireland (n = 59) Student Attitudes to Consumer Participation
Increase: Consumer involvement
Other attitude domains, not statistically significant
In Ireland, for attitudes to consumer participation, very similar findings to Australia
Attitude to consumer involvement in MH services were high at pre-test. Still a statistically significant improvement at post.
Of the other domains, trends went in intended direction for: lack of capacity (down), consumer academic (up), consumer as staff (up)

9. Student Attitudes about Mental Illness & Mental Health Nursing
Finland n = 63
Increase: Preparedness for Mental Health Field
No change: Valuable Contribution of MHN
(already high at pre-test)
Decrease: Negative Stereotypes
Decrease: Social Distancing
Statistically significant improvements:
Increased preparedness
Reduction in negative stereotypes
Reduction in social distancing
At baseline there was already high levels of view that MHN makes valuable contribution

10. Finland (n = 63) Student Attitudes to Consumer Participation Increase:
Consumer involvement
Consumer as staff
Aimed for changes seem to have taken place for all attitudes regarding consumer participation.
Of these, the statistically significant ones were:
Improvement in consumer involvement
Improvement on consumer as staff

11. “I intend to pursue a career in psychiatric/MHN”
These are the averages for raw responses to the item: ‘I intend to pursue a career in psychiatric/mental health nursing’.
The vertical axis represents the range of ratings on the scale: 0: strongly disagree, to 7: strongly agree
Irish students did not do this item as they were all already in a specialist MHN course.
Australia: increase in intentions, though not statistically significant.
Finland: compared to Australia, at baseline was lower on intentions. At post-test the increase was statistically significant at p<.05 (p=.028)

12. Focus groups with students
Students asked to describe the experience of being taught by an EbyE:
Positives or benefits
Negatives or challenges
Likely impact on nursing practice?
Importance of mental health skills for nursing more broadly?
Data from Australia, Ireland, Norway, the Netherlands
Questions are a selection for purposes of this presentation
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13. ‘People like us’
Students described a far greater understanding of the person as much more than a diagnosis and collection of signs and symptoms:
People with mental health problems are ill just like people with somatic illness and they have somatic illnesses. They are like us no difference FIN.
COMMUNE

14. ‘Person beyond the diagnosis’
if I met her [EbyE) when she was like that…. how would I have thought of her? Would I have bothered to find out what was going on inside there, or would I have just looked at the mess and been, like, too hard basket … this does not mean the end of someone’s life because at this moment they’re going through this issue, this is just a moment in time that we can move through [AUS]
COMMUNE

15. Improving person-centred nursing practice…
“(I) will probably … think a bit more … about it - the patient’s side – when we have had it so close … it is still with us what they told about how they experienced things … at least try my best to be a good nurse and a support for the patients. To see the patients, and user involvement, is incredibly important … a fellow human of equal worth … meet the patient on the same level … [NOR]
COMMUNE

16. Learning beyond the medical model
I would have thought the whole thing about mental health nursing being honest before was that we had to understand the conditions; I didn't think we'd have to an extent have as much an influence on their recovery [IRE]
medication is only one small part of mental health [IRE]
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17. Beyond theory
“I think it is an advantage that we get lessons from an EbyE. You can read as much theory as you want, but in the end you just don’t learn from that what a person like that has to go through.” [NETH]
COMMUNE

18. Becoming critical
We are trained from the hospital’s and the nursing department’s point of view. You do not always realize how your own views are limited. You think you are critical and then you realize, when you meet them [the EBEs], that maybe you are not so critical and broad minded. Why do we do what we do, like using the ICD diagnostic system? Sometimes you just do things blindly. ICE

19. Involving Experts by Experience in mental health nursing education:
positively influences attitudes towards people diagnosed with mental illness
enhances popularity of mental health nursing
encourages students to provide person-centred care which furthers recovery
is seen as relevant for all areas of nursing practice
COMMUNE

20. The whole wonderful Commune team, and particularly:
Acknowledgements
The whole wonderful Commune team, and particularly:
Ms Julia Bocking, Consumer Academic
Dr Brett Scholz, Research Fellow
Dr Chris Platania-Phung, Research Fellow

21. Publication
Happell, B., Platania-Phung, C., Scholz, B., Bocking, J., Horgan, A., Manning, F., Biering, P. (2018). Changing attitudes: The impact of Expert by Experience involvement in Mental Health Nursing Education: An international survey study. [Article in Press]. International Journal of Mental Health Nursing. doi: /inm.12551

22. THANK YOU!