Exploring Mental Health Nurses' Perspectives on the Australian Stepped Care Model in Primary Mental Health Services

Abstract

Primary healthcare remains an essential aspect of mental health service delivery in most developed nations worldwide. Mental health nurses (MHNs) play an important role in the delivery of mental health care within primary health care settings. This study, a subset of a broader study, explores MHNs’ experiences of the stepped care model (SCM) in Australian primary mental healthcare. Through semistructured interviews, the exploratory descriptive inquiry study explores the perspectives of eight MHNs on the implementation and effectiveness of the SCM across diverse settings, delving into their roles, motivations, approaches to care, experiences and the challenges encountered. Five themes were identified: the diverse roles of MHNs in the SCM, motivation to work in SCM, a consumer-centred approach, challenges of the SCM and ‘it is great if you can get it’. Findings reveal diverse roles, from delivering psychotherapy to consumers presenting with mild to moderate needs to coordinating care for individuals presenting with severe and complex challenges. MHNs working in the SCM are driven by a desire to provide flexible, recovery-focused care. They prioritise consumer-centred approaches and tailored care to meet individual needs. They experience challenges, including professional isolation in some cases, resource constraints, limited session availability for the consumers they work with and administrative burdens. The study underscores the need for structural enhancements to optimise the SCM's effectiveness and meet diverse consumer needs. These insights from MHNs are relevant to policymakers, Primary Health Networks (PHNs), service providers and clinicians. Future research could expand the scope to include perspectives from various disciplines involved in the model, as well as consumers and carers accessing SCM services. Overall, this paper contributes valuable insights to the discourse on the effectiveness of the SCM through the lens of MHNs delivering care within the model.