S.TRUEMAN PhD THESIS 2016

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This study found that visiting MHNs tend to work independently of the remote nurses while in the same community: I think the residential workforce [remote nurses] in those communities often … just don’t get involved, don’t want to get involved, it’s not their specialty. [Psychiatrist, T10, p. 13] Visiting MHNs are usually based in an office of the primary healthcare centre, but do not actively work in conjunction with the remote nurses. Hence mental health patient interviews, consultations and depot injections are undertaken automatously. Nurse participant explanations involved limited time, staff resources and work pressures: There’s only two nurses here, they can’t afford me to be off the floor for an hour to go and sit and listen to a mental health person. I’ve got clients to see. [T4, p. 13] No, because you’ve got your own stuff going on. As a result of that, it’s very difficult to marry up with them [mental health nurse] and work with them and see how they operate. [T7, p. 11] One participant mental health nurse’s perspective was more attitudinal: A lot of times the attitude of [remote nurses] … they’d rather not deal with mental health patients … they equate mental health with violence … as opposed to someone in crisis, they just see [mental health] differently. [T17, p. 12] Seeking information from MHNs concerning mental health patients is undertaken ad hoc as opposed to formally. Mental health nurse teams infrequently make formal handovers to remote nurses concerning mental health patients when departing from the