Victorian Mental Health Nurses' Experiences of Mental Health Reform: A Qualitative Descriptive Study

Abstract

The state of Victoria, Australia is currently in a period of mental health reform, spurred on by a recent damning Royal Commission and updates to legislation. New legislation promotes the choices and rights of consumers in the mental health system, including recommendations to eliminate seclusion by 2030. While much of this reform has been met with enthusiasm by consumer groups and nurses alike, there remains uncertainty. The aim of this paper is to describe the experiences and perceptions of mental health nurses on mental health reform in the State of Victoria, Australia. Adopting a qualitative descriptive method, mental health nurses (n = 14) working in public mental health services in Victoria undertook individual interviews, with data thematically analysed. After analysis, three themes were identified: Navigating the new Act: Overcoming Managing challenges faced by mental health nurses, Defusing the storm: Mental health nurses' safety concerns under the new Act, and Workforce strain and organisational value: The impact on mental health nurses. Nurses described distress at working in a system with increasing occupational pressures and expressed concern that the goal to eliminate seclusion by 2030 may not be achievable due to current system constraints and deficits. They also highlighted legislative barriers that prioritised consumer preferences over clinical judgement, which they perceived as contributing to a decline in consumer wellbeing and, in some cases, serious adverse outcomes. While mental health reform is essential to improving care, it must also consider the practical and emotional demands placed on clinicians within evolving legislative frameworks. This study identified that the implementation of mental health reform requires a consistent approach by health services and government that promotes the needs of consumers whilst also balancing the significant workplace stressors that nurses encounter. Plans to eliminate restrictive practices need to adopt a consistent, collaborative approach that recognises the complexity of current challenges and the importance of thoughtfully addressing the underlying factors, rather than simply removing existing responses.