Review: exploring the role of mental health nurse-practitioner in the treatment of early psychosis

Authors

  • Megan Morse,

    1. Authors:Megan Morse, MN, RN, Clinical Nurse Consultant, Court Liaison Service – Community Forensic Mental Health Service, Spring Hill, Qld; Nicholas Procter, PhD, MBA, RN, Chair, Mental Health Nursing, School of Nursing and Midwifery, University of South Australia, Adelaide, SA, Australia
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  • Nicholas Procter

    1. Authors:Megan Morse, MN, RN, Clinical Nurse Consultant, Court Liaison Service – Community Forensic Mental Health Service, Spring Hill, Qld; Nicholas Procter, PhD, MBA, RN, Chair, Mental Health Nursing, School of Nursing and Midwifery, University of South Australia, Adelaide, SA, Australia
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Professor Nicholas Procter, Chair, Mental Health Nursing, School of Nursing and Midwifery, University of South Australia, City East Campus, North Terrace, Adelaide, SA 5000, Australia. Telephone: +61 8 8302 2148.
E-mail:nicholas.procter@unisa.edu.au

Abstract

Aims and objectives.  The aim of this paper is to examine high-level evidence in early intervention in psychosis and scope the potential role of the mental health nurse-practitioner in the treatment of management of early psychosis.

Background.  Psychosis imposes complex symptoms that impact on the individual and their social network, often resulting in long-term disability. As specialised early intervention in psychosis is emerging, the nurse-practitioner role in mental health is also gaining momentum. The background literature highlights several critical synergies between nurse-practitioners’ scope of practice and needs of patients with early psychosis.

Design.  Literature review.

Method.  Electronic databases including Cochrane Library, CINAHL, Medline, TRIP and EMBASE. Searching was limited to articles published between 1988–2009. Eligible studies were limited to systematic reviews and randomised controlled trials.

Results.  Two systematic reviews and five randomised controlled trials met the inclusion criteria. No studies were located which specifically addressed the nurse-practitioner role in early psychosis.

Conclusions.  Specific interventions require further research but there is emerging evidence that specialised intervention for people in the early phase of psychotic illness is achievable and possibly essential. It is within the scope of practice of mental health nurse-practitioners to ensure patient and carer education and support, adherence to medication and other treatments, promotion of social inclusion and social connectedness.

Relevance to clinical practice.  Mental health nurse-practitioners have the potential to provide specialist support to meet the needs of this complex group. Central to this is an ability to build an evidence-base around the treatment and management of people with early psychosis and deliver effective education and leadership across clinical, inter-professional and organisational domains. The paper concludes by positing a set of recommendations for nurse-practitioners in the field of early psychosis in the Australian mental health setting.

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