In the second year of my nurse training, I realised I wanted to continue my education and advance my practice once I qualified as a mental health nurse (MHN). At that time, I thought of undertaking an advanced nurse practice course or specialising in one of my other areas of interest. I have a professional interest in psychosis and am a member of the International Society for Psychological and Social Approaches to Psychosis.
About a year into my practice I stumbled upon a masters that not only sparked my interest, but also appeared to explore all the questions left from my nurse training. So, in 2019, I am undertaking a masters in psychology and neuroscience of mental health.
I learned a lot from my nurse training and it was one of the most rewarding challenges I have done. But a few aspects perplexed me and have been magnified during my time in practice – some of these things have drawn me towards neuroscience.
As part of our MHN training we are taught several models for the pathology and treatment of mental health – the medical model, the biopsychosocial model and the holistic model. I was left asking: how does the biological and neurological pathology meet with the psychological experience of an individual and the symptomology that we are assessing? In short, how does all of this link?
Let’s put aside the social normalisation argument for now (that would be another blog entirely), when we look at an individual’s psychiatric pathology do we know how this translates to a psychological, biological or behavioural pathology? Can we say with certainty we know how and why mental illness starts? I left my degree with the answer always being: “It’s a combination of factors.”
I think the reason this bothers me so much is because, like so many others, I want to deliver mental health nursing care that is current, integrated and evidence-based. Yet I can't overcome this uncertainty underpinning my everyday practice.
As I moved through my training and early career I came to describe this challenge as an old-fashioned TV – if you take off its back you can see all the wiring, what connects to where, and monitor the electrical signals. Yet none of this (for me, anyway) clearly answers how this is translated on to the screen, nor can it explain the type of programmes shown or how they are interpreted by viewers.
Something else that stuck with me while training was a passage I found in the Biological Basis for Mental Health, stating that schizophrenia could be up to eight different illnesses. This shocked me, since it was the first and last I would hear of this through my training, and because our care and treatment of schizophrenia is still based on the symptomology of one psychiatric diagnosis.
I had a similar feeling recently when I heard about trials to discover whether PET scans could be used to establish whether dopamine-based anti-psychotics are going to be effective for people who suffer psychosis. This struck me so strongly because I feel that being able to scan people before we give medications with serious side effect profiles would be revolutionary. It gave me hope and motivation to find ways to bring this kind of treatment into my everyday practice.
So why did I choose neuroscience? Firstly, this masters will allow me to study psychiatry, psychology, sociology and neuroscience side by side. Secondly, it will help fuel my passion for integrating evidence into mental health nursing and hopefully reveal paths to contributing to this area. Finally, and most importantly in my day-to-day practice, neuroscience can help me learn what helps people and why, so I can better understand and help the people I work with.