Nursing assessment of mental health issues in the general clinical environment: A descriptive study

Irene Ngune; Beverley Ewens; Sharlene Bell; Brendon Burns; Claire Sutton; Craig Creswell; Yvonne Middlewick

doi:10.1111/jan.16214

Nursing assessment of mental health issues in the general clinical environment: A descriptive study

J Adv Nurs. 2024 May 13. doi: 10.1111/jan.16214. Online ahead of print.

Authors

Irene Ngune¹, Beverley Ewens¹, Sharlene Bell², Brendon Burns², Claire Sutton², Craig Creswell², Yvonne Middlewick¹

Affiliations

¹ School of Nursing and Midwifery, Edith Cowan University, Joondalup, Western Australia, Australia.
² Joondalup Health Campus, Joondalup, Western Australia, Australia.

PMID: 38738987
DOI: 10.1111/jan.16214

Abstract

Aims: To evaluate the effectiveness of a mental health screening form for early identification and care escalation of mental health issues in general settings. A secondary aim was to explore general nurses' use of the form and their confidence to discuss mental health issues with patients.

Methods: A cross-sectional design comprising a review of clinical records to determine use of the form, instances of missed care and escalation to the mental health team. The survey focused on nurses' confidence in general settings to engage in discussions with patients about mental health. Data were collected from April to December 2022. The Strengthening the Reporting of Observational Studies in Epidemiology Statement guided this study.

Results: Of 400 patient records, 397 were analysed; 293 (73.8%) of those had mental health screening by nurses. Age was a significant factor, with younger patients more likely to be screened although concerns were typically recognized in older patients. Of the 20 patients identified with mental health concerns, 9 (45%) were referred for further evaluation by the Clinical Liaison Team. While nurses were proactive in assessing physical risks, assessing risk factors that required deeper conversations with patients, including psychiatric history, was lacking. The survey highlighted fewer than half of the respondents (46%, n = 10) felt competent to engage in discussions about mental health; however, most (59%, n = 13) knew when to seek a mental health referral.

Conclusions: General nurses have a role in the early identification and referral of patients with mental health challenges. However, training is imperative to facilitate deeper patient interactions concerning mental health. Integrating mental health checks within general settings is crucial for early detection and intervention, aligning with global quality care standards.

Reporting method: STROBE guidelines.

Patient or public contribution: We received feedback that shaped the research protocol from a consumer representative.

Keywords: adult nursing; mental health; nurse roles; quantitative approaches; screening.