title: 'Your experiences were your tools'. How personal experience of mental health problems informs mental health nursing practice.
abstract: WHAT IS KNOWN ON THE SUBJECT?: 'Expertise by experience' has become an increasingly valued element of service design and delivery by mental health service providers. The extent and influence of mental health professionals' personal experience of mental ill health on clinical practice has seldom been interrogated in depth. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: We investigate how mental health nurses' own personal experience of mental ill health informs their mental health nursing practice with particular reference to direct work with service users. Participants said that personal experience could impact on work in three positive ways: to develop their relationship with service users, to enhance their understanding of service users and as a motivation for potential mental health nurses to join the profession. This study moves the discussion of the state of mental health nurses' mental health further towards the recovery and well-being focus of contemporary mental health care, where 'expertise by experience' is highly valued. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: We must address the taboo of disclosure within clinical nursing practice and debate the extent to which personal and professional boundaries are negotiated during clinical encounters.
  Introduction 'Expertise by experience' is a highly valued element of service delivery in recovery-oriented mental health care, but is unacknowledged within the mental health nursing literature. Aim To explore the extent and influence of mental health professionals' personal experience of mental ill health on clinical practice. Method Twenty-seven mental health nurses with their own personal experience of mental ill health were interviewed about how their personal experience informed their mental health nursing practice, as part of a sequential mixed methods study. Results The influence of personal experience in nursing work was threefold: first, through overt disclosure; second, through the 'use of the self as a tool'; and third, through the formation of professional nursing identity. Discussion Mental health nurses' experience of mental illness was contextualized by other life experiences and by particular therapeutic relationships and clinical settings. In previous empirical studies, nurses have cited personal experience of mental illness as a motivator and an aspect of their identity. In this study, there was also an association between personal experience and enhanced nursing expertise. Implications for practice If drawing on personal experience is commonplace, then we must address the taboo of disclosure and debate the extent to which personal and professional boundaries are negotiated during clinical encounters.
authors.affiliation: Florence Nightingale Faculty of Nursing and Midwifery, King's College London, London, UK.
authors.forename: J
authors.identifier: http://orcid.org/0000-0001-7745-9539
authors.initials: J
authors.lastname: Oates
authors.affiliation: School of Health Sciences, City University London, London, UK.
authors.forename: N
authors.initials: N
authors.lastname: Drey
authors.affiliation: Patient Experience and Public Involvement, Centre for Research in Primary and Community Care (CRIPACC), School of Health and Social Work, University of Hertfordshire, Hatfield, UK.
authors.forename: J
authors.initials: J
authors.lastname: Jones
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D028642:Persons with Psychiatric Disorders / Q000523:psychology*; D008875:Middle Aged; D009726:Nurses / Q000523:psychology*; D011568:Psychiatric Nursing / Q000379:methods*; D014342:Truth Disclosure
keywords: mental health nursing; nursing role; qualitative methods; recovery; therapeutic relationships