Institute for Health Transformation, School of Nursing & Midwifery, Deakin University, Geelong, Victoria, Australia.
School of Nursing, College of Health and Medicine, University of Tasmania, Hobart, Tasmania, Australia.
Int J Ment Health Nurs. 2022 Aug;31(4):908-919. doi: 10.1111/inm.12998. Epub 2022 Mar 25.
The recently released Victorian Mental Health Royal Commission report has recommended a shift to integrated treatment, defined as treatment for alcohol and substance use disorders and mental ill health occurring in parallel, rather than distinct systems catering to each need. However, little work has sought to determine the perceptions of nurses working in alcohol and other drug (AOD) treatment towards integrating with mental health services. In this study, we explore the perspectives of specialist AOD nurses towards the integration of mental health and AOD treatment services. Secondary analysis of semi-structured interviews with Australian specialist AOD nurses (n = 46) conducted as part of a wider workforce study in 2019. Data were analysed using thematic analysis and reported using the COREQ guidelines. Of the interviews analysed, six were AOD nurses working in an Australian state that had recently undergone service integration; however, many participants expressed perceptions of service integration. Two key themes are reported in this paper: (i) perceptions of service integration, where AOD nurses participating in our study were concerned that integration would result in the model of care they worked under being replaced by a mental health-based model that was felt to be highly risk averse, and (ii) experiences of service integration. Concerns about the focus of care as well as the complexity of care differing between the two services demonstrated a contrast in both philosophical approaches to work with consumers and legislative difference in voluntary versus compulsory care provision.
最近发布的维多利亚精神健康皇家委员会报告建议转向综合治疗，即并行治疗酒精和物质使用障碍以及心理健康问题，而不是为每种需求提供不同系统的治疗。然而，很少有研究试图确定在酒精和其他药物（AOD）治疗方面工作的护士对与心理健康服务整合的看法。在这项研究中，我们探讨了专科 AOD 护士对心理健康和 AOD 治疗服务整合的看法。这是对 2019 年进行的更广泛劳动力研究中澳大利亚专科 AOD 护士（n=46）进行的半结构化访谈的二次分析。使用主题分析对数据进行分析，并按照 COREQ 指南进行报告。在所分析的访谈中，有 6 名 AOD 护士在澳大利亚一个最近进行了服务整合的州工作；然而，许多参与者表达了对服务整合的看法。本文报告了两个关键主题：（i）服务整合的看法，参与我们研究的 AOD 护士担心整合会导致他们所遵循的护理模式被一种被认为高度规避风险的以心理健康为基础的模式所取代，以及（ii）服务整合的经验。对护理重点的关注以及两种服务之间护理复杂性的差异，表现出在与消费者合作的哲学方法以及自愿与强制护理提供方面的立法差异方面存在差异。
