Mental health nursing practice in rural and remote Canada: Insights from a national survey.
Martha L P MacLeod, Kelly L Penz, Davina Banner and 5 others
PMID 34668279WHAT IT FOUND
In rural Canada, most nurses providing mental health care are generalists, not specialists.
They reported moderate resources but high safety concerns, with over half experiencing or witnessing violence in the previous four weeks.
Key findings
01Most nurses providing mental health care in rural and remote Canada practice in other areas like acute, primary, or long-term care, rather than specializing in mental health.
02More than half of the nurses surveyed experienced or witnessed violence in the workplace in the previous four weeks.
03Nurses with a 'mental health plus' practice (mental health alongside other areas) reported significantly fewer job resources, particularly in staffing, time, and training, compared to those practicing only in mental health.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study is cross-sectional, so it describes associations but cannot determine causality. The survey data was collected between 2014 and 2015, which may not reflect current post-pandemic conditions or recent changes in mental health service delivery. The analysis may have underestimated the number of nurses providing mental health care because it relied on nurses specifically defining 'mental health' as an area of practice. The job resource and demand scales measured nursing practice as a whole and may not have captured the specific complexities of mental health practice.
Declared interests
Funded by the Canadian Institutes of Health Research. The authors declared no conflicts of interest.
The easy way to misread this
Do not interpret the lower resources reported by 'mental health plus' nurses as evidence that they are less competent or that their care is of lower quality. The study reports their perception of workplace supports (staffing, time, training), not patient outcomes or clinical skill levels.