Eighteen months ago, mental health nurse educator Scott WT Trueman was working at a small Primary Healthcare Centre (PHC) in an Indigenous community in Cape York when he was called to help assist with a “psychotic” young man in police custody.
Nurses at the PHC feared the man was dangerous while the police wanted to detain or imprison him.
“All of the PHC staff were interstate or overseas generalist nurses who didn’t have any real understanding of the situatedness of Cape York or Indigenous people,” Scott said.
“I took this young lad aside. It was a dry community but I could smell stale alcohol on him.
“Whilst it took some time to gain a rapport, it was clear that all that had happened was that his father had died about three months ago and
he was grieving for him.
“He had drunk four bottles of spirits with three other lads. He was calling out his father’s name in traditional language so that his father’s spirit could enter his body, and in entering his body he would become a proud warrior like his father.
“It had nothing to do with mental health at all.
“He was doing something that was culturally totally appropriate for him in his grieving process.
“If I wasn’t there, it worries me that he would have been labelled psychotic and that label would have stuck with him forever, having been recorded.
“Alternatively he could have been detained under the Mental Health Act.
“I simply said to him, you are obviously grossly hung-over and I think you should have a glass or two of water and head to bed.
“I often reflect upon this as a win for mental health nursing.
“Afterwards, I attempted to speak to the PHC staff, but they didn’t want to address or discuss the eventuality, which is consistent with generalist nurses’ attitudes to this type of mental health presentation.”
Scott, who works for the Rural and Remote Mental Health Service, a “fly in and fly out service” that visits communities throughout Cape York and the Islands of the Torres Strait, said many generalist nurses often find it difficult to know, or feel confident, in how to approach and care for mental health patients.
“They are generally very unsure, very critical of their actions and decisions and very unaware of the excellent work that they have in fact instigated or undertaken in a resource depleted environment,” he said.
“I am interested and committed in trying to lift the importance and attractiveness of mental health nursing as part of core generalist nursing, so that when nurses do interact with mental health clients they feel more confident in dealing with these clients on an equal basis.”
Originally from South Australia, Scott trained and worked in general nursing and eventually took time out to return to university to study both law and accounting, qualifying as both a lawyer and in accounting, but Scott realised he still hadn’t found his niche.
“Being interested in people, as human beings; their complexities, world views, diversities and goals at that reflective time in my life, I wasn’t turned on by the bells and whistles of modern generalist nursing and I was becoming more interested in people, people with mental health illness and their integration with society,” he said.
“I thought mental health nursing would be a good fit.”
Scott graduated with a Diploma in Mental Health Nursing and worked in clinical roles within a range of mental health facilities, and attained a Master’s Degree in Mental Health Nursing and is currently completing a PHD, through James Cook University, in Mental Health Nursing.
Next month, Scott begins an exciting new phase in his career – as a nursing and mental health lecturer with James Cook University.
“I like the interaction with mental health clients because so many are, in their own way, engaging, presenting with complex issues, and just trying to understand their world view and where they personally sit with their mental health issues is challenging,” he said.
“If one is lucky enough it’s terribly enjoyable to see somebody make the best of themselves in a recovery sense, and despite their mental health illness be able to function as a member of society.
“That’s a powerful thing.
“Mental health patients are usually stigmatised, marginalised and disempowered from mainstream society,” Scott said.
“Because I spend so much time with the Indigenous population I can see that social determinants are poor for indigenous people in the remote communities that I go to, and just by alleviating some of the concerns, problems and pain they feel is a step in the right direction.
“Life for a lot of people in these communities is pretty bleak.
“If you are able to shine a bit of sunshine into people’s lives, in spite of the social determinants not changing; if you can alleviate some of their mental health symptoms and make their life a little bit more bearable - that’s a significant and rewarding outcome.”