Providing timely and equitable access to high-quality health care by reducing wait times for assessment and treatment is a top priority for health-care providers, advocates, policy-makers and indeed, for Canadians in general. However, health-care priorities need to include a focus on mental health.
Mental health conditions like anxiety and depression affect one in five Canadians. Psychological factors associated with these and other mental health conditions can affect how well people maintain their health and manage comorbidities. Improving access to the range of biological, psychological and social assessments, screening and interventions required to meet the needs of persons experiencing mental health problems and illnesses and their families is critical.
Registered nurses (RN) working in all practice settings and along every point across the continuum care for people with varying degrees of mental health and illness every day:
· Public health and primary care nurses assess and screen new mothers for post-partum depression.
· Nurses working in emergency departments respond to patients experiencing acute psychotic episodes.
· Primary care nurses screen for and provide education around substance use and abuse.
· Street health nurses care for people who may be homeless and/or engaging in high-risk behaviours, in part because of an unmanaged mental illness.
· School nurses assess children and youth for the presence of eating disorders, bullying and abuse.
· Critical care nurses care for families experiencing grief, loss and crisis.
· Medical/surgical nurses care for patients experiencing acute delirium, depression and anxiety.
· Psychiatric/mental health nurses often care for individuals who are at risk for self-harm or experiencing suicidal ideation.
- Nurses working in First Nation communities deal with intergenerational effects of trauma and abuse.
As holistic practitioners and care providers, we utilize our knowledge, expertise and therapeutic interactions to care for the mental health and well-being of individuals, communities and populations. Our numbers, our distribution and our role as knowledge professionals means that we are well-positioned to provide the leadership and solutions necessary to drive improvements in mental health service delivery.
Nurses have extensive clinical expertise and have demonstrated leadership in providing mental health services to Canadians, including health promotion, illness prevention, early detection, diagnosis, intervention, crisis management, rehabilitation and (especially) recovery. Because nurses can often identify the early signs of mental illness, and the life conditions that contribute to it, they are well-positioned to offer early interventions that can mitigate a deteriorating personal situation. Ideally, the contributions of nurses and other health-care providers are most effective when offered through interprofessional collaborative approaches. In this updated position statement, CNA promotes the formal inclusion and involvement of families, caregivers, consumers and consumer groups in the planning, delivery and evaluation of mental health services, including the provision of care and self-management.
CNA, in a 2011 brief to the House of Commons Standing Committee on Finance, told the committee that targeted improvements in community health and mental health care across the continuum can be realized through the implementation of the recommendations outlined in the Mental Health Commission of Canada’s (MHCC) mental health strategy for Canada. This strategy will advance a comprehensive population-based approach to mental health — one that emphasizes broad community-based services and recovery-based approaches and acknowledges the pivotal role of consumers and front-line providers in implementing system change. One of the most promising aspects of this strategy is that it emphasizes fostering good mental health for all Canadians, not just treating problems and illnesses when they arise. CNA is keenly aware that resources to support knowledge translation and change management opportunities will be necessary to support the implementation of the MHCC’s recommendations.
The principles of primary health care (PHC), as outlined in the World Health Organization’s 1978 Alma Ata declaration, are foundational for optimizing the health of all populations and improving the performance of health systems: (1) accessibility; (2)active public participation; (3) health promotion and chronic disease prevention and management; (4) the use of appropriate technology and innovation (including knowledge, skills and information); and (5) intersectoral cooperation and collaboration. In celebrating 35 years since the signing of this declaration, and to portray the relationships among PHC’s values, principles and concepts, CNA has developed the following conceptual model.
PHC is about far more than delivering health-care services. It’s about creating the conditions that support health and wellness. For more information, see our Conceptual Model: Primary Health Care page and position statement on PHC.
Utilizing its voice, leverage and actions, CNA continues to advocate for a system that supports the mental health and wellness of all people living in Canada and those on the journey toward recovery, and collaborates with national and jurisdictional partners in support of this agenda. CNA is committed to working with other health-care professionals and organizations to ensure public policy and practice best meets the mental health needs of Canadians.
CNA is the national professional voice of registered nurses in Canada. A federation of 11 provincial and territorial nursing associations and colleges representing nearly 150,000 registered nurses, CNA advances the practice and profession of nursing to improve health outcomes and strengthen Canada’s publicly funded, not-for-profit health system.