The Unique Role of Mental Health Nurse Practitioners to Improve Healthcare Access: A Qualitative Study

The prevalence of mental health and substance use disorders is growing in Aotearoa New Zealand, with rising unmet need and health services under immense pressure. Nurse practitioners (NPs) have the potential to transform healthcare delivery and improve healthcare access and health equity. However, little is known about how they work and deliver services. This qualitative descriptive study explored how mental health nurse practitioners from diverse healthcare settings across Aotearoa New Zealand delivered care to improve access to mental health and substance use services and promote health equity for individuals, families, and communities. Ten mental health nurse practitioners from across Aotearoa New Zealand and from diverse secondary, primary and community settings participated in individual interviews, face to face or by zoom. The interviews were transcribed and thematically analysed. Three key themes were identified: 1) Being there: The unique role of nurse practitioners; 2) Bridging nursing and biomedicine: A foot in both camps; and 3) Working collaboratively across teams, places and spaces. Each nurse practitioner had developed their own unique model of service delivery, working creatively and flexibly to deliver services which were culturally appropriate, trauma-responsive and holistic to individuals and whānau (families) underserved by mainstream services. They created strong collaborative relationships with a range of service providers and moved seamlessly between health sectors. Investing in the mental health nurse practitioner workforce and facilitating them to create innovative and alternative models of care will help to address health need and transform service delivery. Te reo Māori translation Te tūranga ahurei o te mātanga tapuhi hauora hinengaro i te whakapikinga o ngā ratonga, hei whakapiki i te tomopai: He rangahau ine kounga i mahia i Aotearoa New Zealand Ngā Ariā Matua E tupu ana te putanga mai o ngā hē hauora hinengaro, whakamahi taruhea hoki i Aotearoa, ā, kei te piki ngā hiahia kāore i tutuki, kei te tāmia hoki ngā ratonga hauora e ngā pēhanga o te wā. Mā ngā mātanga tapuhi (NPs) e whakumu pea te āhua o te horanga taurimatanga hauora, e whakapiki hoki te taurimatanga, me te tautika hauora. Ahakoa tērā, he iti noa iho ngā mea e mōhiotia ana mō te āhua o tā rātou mahi me tā rātou hora ratonga. Nā tēnei rangahau ine kounga whakaahua i tūhura i pēhea te hora taurimatanga a ētahi mātanga tapuhi hauora hinengaro mai i ngā horopaki taurima hauora huhua puta noa i Aotearoa hei whakapiki i te tomopai ki te hauora hinengaro, ki ngā ratonga whakamahi taruhea me te whakapiki i te tautika hauora mā ngā tāngata takitahi, mā ngā whānau me ngā hapori. Tekau ngā mātanga tapuhi hauora hinengaro mai i ngā tōpito o Aotearoa me ngā horopaki tuarua, tuatahi, hapori huhua hoki, i whai wāhi ki ngā uiuinga takitahi, ā-kanohi, ā-ipurangi rānei. I tuhia katoatia ngā uiuinga, ā, i tātaritia i runga i ngā tāhuhu i puta. E toru ngā tāhuhu matua i tautohutia 1) Te noho tata: Te tūranga ahurei o te mātanga tapuhi hauora hinengaro; 2) Te whakapipiri i te ao tapuhi ki te ao tākutatanga auraki: He waewae i tētahi ao, he waewae anō i tētahi; me te 3) Te pāhekoheko whakawhiti noa i ngā tira, i ngā wāhi me ngā taiwhanga. Kua oti tāna ake tauira hora ratonga te whakawhanake e ia mātanga tapuhi hauora hinengaro, kua mahi tahi i runga i te auaha me te pīngawingawi ki te hora ratonga hāngai ā-ahurea, urupare ki te kōhuki, arowhānui hoki ki ngā tāngata takitahi me ngā whānau, kāore i tukua ki a rātou e ngā ratonga hauora auraki. I hangaia e rātou ētahi hononga pāhekoheko pakari ki te huhua o ngā kaihora ratonga, ā, he rōnaki noa tā rātou whakawhiti i waenga i ngā rāngai hauora. Mā te haumi ki te ohu kaimahi mātanga tapuhi hauora hinengaro me te āwhina i a rātou ki te hanga tauira auaha, tauira rerekē hoki, e āwhina te whakatutukitanga hiahia hauora, me te whakaumu horanga ratonga.