Nurses are the key to improving mental health services in low- and middle-income countries.
Mental health nursing is a critical issue for most countries. Nurses in low- and middle-income countries are often the primary providers of care for people with mental disorders. Some are highly qualified professionals who train other providers to identify and treat mental disorders. However, in other instances, particularly in low-income countries, nurses have had very little or no mental health training and receive no support from mental health professionals. The lack of sufficient mental health professionals in these countries creates an environment where nurses without training are often the only providers available to care for people with mental disorders. In September 2007 the World Health Organization and the International Council of Nurses produced a report summarizing the responses to some of the questions on a survey of nursing mental health practices in 177 countries and territories. The summary of the open-ended questions (e.g. what are the key issues for nurses providing mental health care in your country?) is reported for the first time in this article. Subsequent to the release of the Nurses in Mental Health Atlas, an online forum was held. There were 615 subscribers to this forum from over 80 countries. This article summarizes the rich insights and recommendations from both the survey's open-ended comments and the online forum. The issues discussed include: the varied and complex roles for nurses in mental health care; nursing education; prescribing practices; nurse recruitment and retention; human rights; research; and technical expertise.
Barrett
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Graduate School of Professional Psychology, University of Denver, Denver, CO 80208, USA. thomas.barrett@du.edu
Boeck
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Fusco
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Ghebrehiwet
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Yan
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Saxena
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D001291:Attitude of Health Personnel; D019985:Benchmarking; D003299:Cooperative Behavior; D003479:Curriculum; D003906:Developing Countries; D011307:Drug Prescriptions / Q000451:nursing; D014943:Global Health; D006287:Health Planning Guidelines; D006291:Health Policy; D006293:Health Promotion; D006297:Health Services Accessibility / Q000458:organization & administration; D006301:Health Services Needs and Demand; D006806:Human Rights; D006801:Humans; D008605:Mental Health Services / Q000458:organization & administration*; D024802:Nurse's Role; D015404:Nursing Methodology Research; D010560:Personnel Selection / Q000458:organization & administration; D011361:Professional Competence; D011568:Psychiatric Nursing / Q000193:education / Q000458:organization & administration*; D017749:Total Quality Management / Q000458:organization & administration*