The purpose of the RNAO Nurse Educator Mental Health and Addiction Resource is primarily to support educators with effectively integrating mental health and addiction knowledge and skills into the undergraduate nursing curriculum. The resource is based on the Canadian Association of Schools of Nursing (CASN) and the Canadian Federation of Mental Health Nurses (CFMHN) Entry- to-Practice Mental Health and Addiction Competencies for Undergraduate Nursing Education in Canada (2015) and supporting research. Each section of the resource has been intentionally aligned with the competencies. Please see Appendix A for a chart showing this alignment. Integration of core concepts, competencies and best practices found in this resource will raise the profile of psychiatric and mental health practices for nurses as an essential component and integral part of holistic person-and family-centred care across all sectors.

As such this resource is also relevant to nurse educators working in clinical environments to support nursing students, new graduate nurses and other nurses in integrating best practices related to mental health and addiction. Other beneficiaries of this resource include nursing students, nurses, other health care providers, and, ultimately, the person and their family receiving care.

The resource is designed to be user-friendly with topic areas easily accessible for review and use. Tools can be completed online or in a paper version and reproduced for curriculum and day-to- day use.

It is recommended to review this resource by examining the table of contents and bookmarking areas for further review or use at critical points in education and practice activities. On the other hand one may identify key areas right away to review in more depth and get started. Others may wish to use the resource as a reference and/or a validation resource. Regardless of how this document is used, there is much satisfaction to be found in expanding knowledge and skill levels in mental health and addiction and working to enabling others to do the same.

SECTION ONE: Introduction

Section one provides the user with the background information for the creation of this resource for nurse educators in entry-level nursing education programs, as well as nursing educators in clinical environments. The section also facilitates understanding of fundamental concepts to mental health and addiction.

SECTION TWO: Learning and Teaching Resources to Support Integration of Mental Health and Addiction in Curricula

Section two includes pre-planning assessment tools that enable educators to assess and identify areas for improvement and ongoing development of their teaching practice in a mental health context.

SECTION THREE: Nurse Faculty and Nurse Educator Teaching Modalities and Reflective Practice

Section three includes a discussion of common collaborative, student-centred and strengths- based pedagogies. This section also addresses teaching activities for mental health and addiction nursing that promote reflective practice, as well as techniques to facilitate preceptorship and mentorship.

SECTION FOUR: Student Reflective Practice and Self-Care in Mental Health and Addiction Nursing Education

Section four focuses on incorporating self-reflective practice and self-care into mental health and addiction content.

SECTION FIVE: Foundational Concepts and Mental Health Skills in Mental Health and Addiction Learning Advancement

Section five highlights mental health, illness and addiction foundational concepts and skills for incorporation into undergraduate nursing curricula.

SECTION SIX: Legislation, Ethics and Advocacy in Mental Health and Addiction Nursing Practice

Section six provides educators with information about key concepts related to mental health and addiction legislation in Canada. Aspects addressed include the relationship of legislation, human rights and autonomy within an ethical framework.

SECTION SEVEN: Clinical Placements and Simulations in Mental Health and Addiction Nursing Education

Section seven provides educators with evidence-based insights into mental health and addiction practice and simulation learning modalities.

SECTION EIGHT

Section eight provides the bibliography as a supplement to those references cited throughout the document.

SECTION NINE: Appendices and Case Studies

Section nine includes appendices, a glossary of terms and case studies. This section provides the educator with tips and tools to integrate best practices related to mental health, illness and addiction into curricula. Case studies represent a spectrum of mental health and addiction scenarios, including individuals of various ages and genders, in a range of clinical settings with an array of mental health, illness and addiction conditions.

Mental health and illness affects all Canadians of all ages, education, income levels and culture. According to the Mental Health Commission of Canada (MHCC), mental illnesses are more common than heart disease and cancer (MHCC, 2013). In fact, in Canada 2.2 million individuals are living with Type 2 diabetes while 6.7 million people are living with a mental illness (MHCC, 2013).

The impact of mental health and illness is complex and far-reaching. A report from the Canadian Chronic Disease Surveillance System (CCDSS): Mental Illness in Canada (2015) demonstrates a relationship between mental illness and chronic diseases (CCDSS, 2015). For example, a higher prevalence of asthma and chronic obstructive pulmonary disease (COPD), ischemic heart disease, diabetes and hypertension, were observed among people using health services for a mental illness than among those using services for other diseases or conditions (CCDSS, 2015). Furthermore, 20 percent of individuals who experience mental illnesses are also experiencing addiction, indicating a high rate of concurrent disorders (mental health and addiction) that presents a further complexity in care (Rush et al, 2008).

The relationship between mental illness, chronic disease and addiction is still poorly understood, despite the fact that individuals with mental illness (e.g., depression, anxiety) are more likely to have a co-morbid chronic condition (e.g., asthma, cardiovascular disease) and that individuals affected by chronic diseases are more likely to experience anxiety and/or depression (CCDSS, 2015).

Given the prevalence of mental illness across the age spectrum and the relationships associated among mental health, illness, addiction and other related conditions, it is evident that nurses across all practice settings will care for clients with mental health and illness conditions (Nadler-Moodie, 2010). Nurses are ideally situated across the continuum of care, to provide timely assessments and evidence-based interventions to individuals who may have either a diagnosed or undiagnosed mental illness.

As referred by CASN/CFMHN, “The complexity of concurrent disorders supports the need for entry-level undergraduate nursing education in Canada to prepare all new RNs to identify, care for and manage these disorders” (Kent-Wilkinson, Blaney, Groening, Santa Mina, Rodrigue & Hust, 2016, p. 8). This resource is designed to help make that a reality.