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Expedited interventions are integral to reducing mental health related morbidity and mortality in general hospital settings. The early recognition of a worsening mental state is essential for optimizing care and treatment of patients in need of specialist assessment, escalation and response. However, a lack of mental health training provides a challenge for generalist clinicians in recognizing clinical cues of variance consistent with a change in mental state, and subsequently acting upon them. In April 2010, Australian Health Ministers endorsed the National Consensus Statement ‘essential elements for recognising and responding to clinical deterioration’ as the standard national framework for recognition and response to patient clinical deterioration in acute care facilities. In 2012, this consensus statement informed the first National Safety and Quality Health Service Standard for recognizing and responding to acute deterioration, which became part of the inaugural Australian Commission on Safety and Quality in Healthcare (ACSQH) National Standards (hereafter National Standards). Generalist healthcare facilities were thus required to develop systems, processes, education and training to address the criteria contained within this National Standard, which initially focussed on physiological deterioration only. However, the 2012 National Standards have since been rescinded and superseded in 2017, where recognizing and responding to acute deterioration also encompasses acute changes in mental state. Consequently, significant attention within healthcare organizations now focusses on screening, monitoring, escalation and referral for, and of, acute deterioration in a person's mental state. However, screening and assessment of a deteriorating mental state has unique nuances and complexities not found in its physiological counterpart, which provide a significant challenge for Australian healthcare organizations, and perhaps consultation liaison nurses in particular, in me

Aim To examine the workforce, workplace, psychosocial and health characteristics of nurses and midwives in relation to their reported use of sickness absence described as ‘mental health days’. Background The occupational stress associated with the nursing profession is increasingly recognized and nurse/midwifery absenteeism is a significant global problem. Taking a ‘mental health day’ as sickness absence is a common phenomenon in Australian health care. No previous studies have empirically explored the characteristics of nurses and midwives using such sickness absence. Design Online cross-sectional survey. Methods Survey comprising validated tools and questions on workplace and health characteristics was distributed to nurses and midwives in New South Wales, Australia, between May 2014 - February 2015. Sample characteristics were reported using descriptive statistics. Factors independently predictive of ‘mental health day’ reportage were determined using logistic regression. Results Fifty-four percentage of the n = 5041 nurse and midwife respondents took ‘mental health days’. Those affected were significantly more likely to be at younger ages, working shifts with less time sitting at work; to report workplace abuse and plans to leave; having been admitted to hospital in previous 12 months; to be current smokers; to report mental health problems, accomplishing less due to emotional problems and current psychotropic medication use. Conclusion Specific characteristics of nurses and midwives who report taking ‘mental health day’ sickness absence offer healthcare administrators and managers opportunities for early identification and intervention with workplace measures and support frameworks to promote well-being, health promotion and safety.

Background: Nursing is an emotionally demanding profession and deficiencies in nurses' mental wellbeing, characterised by low vitality and common mental disorders, have been linked to low productivity, absenteeism and presenteeism. Part of a larger study of nurses' health, the aim of this paper was to describe the mental health status and related characteristics of nurses working in two acute metropolitan teaching hospitals. Methods: A cross sectional survey design was used. Results: A total of 1215 surveys were distributed with a usable response rate of 382 (31.4%). Altogether 53 nurses (14%) reported a history of mental health disorders, of which n=49 (13%) listed diagnoses of anxiety and/or depression; 22 (6%) were currently taking psychoactive medication. Symptoms that could potentially indicate a mental health issue were more common, with 248 (65.1%) reporting they had experienced symptoms sometimes or often in the last 12month. Conclusion: Nurses and their managers should strive to create workplaces where working practices promote nurses' health and wellbeing, or at least are configured to minimise deleterious effects; where both nurses and their managers are aware of the potential for negative effects on the mental health of the workforce; where cultures are such that this can be discussed openly without fear of stigma or denigration.

Perry, L., Lamont, S., Brunero, S., Gallagher, R., Duffield, C. (2015). The mental health of nurses in acute teaching hospital settings: A cross-sectional survey. In BMC Nursing, 14(15). Available here

Lamont,S. ,Brunero,S. , Perry,L. ,Duffield, C.M. ,Sibbritt, D., Gallagher, R., Nicholls, R. (2017). ‘Mental health day’ sickness absence amongst nurses and midwives: workplace, workforce, psychosocial and health characteristics. Journal of Advanced Nursing. 73(5), 1172 - 1181. Available here