'I Felt Like I Was Invisible': Nursing Students' Experiences of Mental Health Clinical Placement-A Cross-Sectional Study.

Australia is currently experiencing a nursing shortage, and the speciality of mental health has been particularly hard hit as it is plagued by student disinterest and difficulty recruiting and retaining nurses. There is also evidence to suggest that when students are on their mental health nursing placement, they experience a lack of learning opportunity, incivility, bullying and are often ignored by nursing staff. Positive experiences during undergraduate mental health clinical placements have been associated with a desire to work in mental health nursing upon graduation. Ensuring students have a positive placement experience, which provides opportunity to link theory and skills, is a priority for sustaining the mental health nursing workforce. This study reports on the mental health placement experiences of a cohort of Victorian undergraduate nursing students enrolled in a Bachelor of Nursing course. Cross-sectional study with thematic analysis of free-text responses and descriptive statistics of placement satisfaction survey (Placement Evaluation Tool: Nursing Student) of data collected between May 2023 and August 2024. Overall n = 264 (26.8%) students were satisfied with their placement (8/10); however, experiences pertaining to constructive feedback, supervision, learning support and feeling valued were rated lower. Additionally, n = 103 (39%) free-text responses on student experience of mental health placement were analysed using thematic analysis, where three themes emerged. Students described placement experiences that were often fraught with incivility and conflict, in addition to being unable to meet learning opportunities. Students were critical of community mental health placements where they were not provided adequate opportunity to engage with consumers or engage in mental health practice. Students reported that the experiences they had on clinical placement significantly influenced their desire to work with both the health service and in mental health. Health services need to address toxic workplace culture, not only for students but for their own staff, and recognise that students are often scrutinising a service for future employment. Despite evidence dating back decades to identify the importance of positive clinical placement experience on recruitment, there remain significant issues in some health services where students are seen as burdensome, and not the answer to the dwindling workforce. Payments by education providers for clinical placement services have been in operation in Victoria, Australia, since 2015; however, it is not necessarily directed to support student placement experience. Health services must be more proactive in identifying their capabilities around supporting undergraduate nursing students, the professional development of staff to provide quality supervision and the suitability and quality of the placement experience they offer.