30/09/2024
Laura McLaughlin
Mental Health Liaison Service (MHLS) Manager (Under 65) Trust wide covering Altnagelvin and the South West Acute Hospital.
How long have you been in your current role?
I was a Band 7 Nurse in the MHLS pilot in 2019, and I moved into the Band 8A Manager role in July 2021.
Tell a little about your career before becoming a Mental Health Liaison Nurse?
I graduated with a first class BSc Hons degree in Mental Health Nursing from Magee Ulster University in 2010. My first job was in a nursing home in Omagh where I worked for 1 year. I then got offered a temporary Band 5 post within the WHSCT in the mental health female admission ward and remained there for a year before moving to the male admission ward for a further 2 years, as my contract was extended. Within this time I also covered the Psychiatric Intensive Care Unit when it was a stand-alone ward.
I then applied for a 3 year Band 6 post covering Mental Health Liaison in SHSCT and was successful, this is what ignited my love of Liaison!
When this contract was due to expire I applied for and was successful in obtaining the post permanently. At the same time I had also applied for a temporary Band 7 post as Substance Misuse Liaison in SHSCT which I was offered and was also successful in being offered a permanent Band 6 post in the Crisis Resolution Home Treatment Team (CRHTT) in WHSCT, which at that stage was in the process of being set up. Keen to return to work closer to home and excited to be part of a new team, I decided to take the CRHTT post. 1 year later I became the Band 7 team leader of CRHTT. Almost 3 years later I was seconded out to the MHLS pilot project in Altnagelvin, this was then put on hold due to Covid In March 2020 and I returned to my substantive post as CRHTT team leader. I then took up my current role in July 2021 as the Band 8A MHLS manager Trust wide to reignite MHLS in Altnagelvin and develop the service in SWAH.
What made you decide to become a Mental Health Liaison Nurse?
My first experience of Mental Health Liaison was when I commenced the post in SHSCT and I instantly loved it. I enjoyed being based in the Acute hospital setting and meeting patients presenting with various physical health issues that may or may not eventually actually be diagnosed mental health issues, experiences that I would not have ordinarily came into contact with working in other areas of Mental Health. I found this interesting and exciting and enjoyed working together with a large multidisciplinary team towards a shared common goal of improving the quality of life for the patient.
My love for Liaison has deepened the longer I work in the area and having obtained a Masters in 2021, I am currently undertaking a PhD part time within the area of Mental Health Liaison to extend my knowledge, skills and understanding of the area in order to ultimately improve the service for patients and staff.
What is the role of a Mental Health Liaison Nurse?
A Mental Health Liaison Nurse works as part of a team which provides assessment and treatment for people with co-existent physical and mental health problems, with the potential to improve both the quality of care and overall outcomes for these individuals. It is a subspecialty of psychiatry in which the nurse provides psychiatric assessment and treatment by working alongside the medical team. For most, but not all, individuals referred to the MHLS the mental health issue is a secondary issue, as opposed to their physical health presentation and primary reason for presenting in the acute hospital. Therefore building strong relationships between MHLS staff and the acute hospital staff are a crucial part of the nurse role for the benefits of the service to be felt for all. MHLS is a response to the overlap between mental and physical problems, and helps to bridge the organisational separation between the mental and physical health services. The nurse role strives to embed mental health services within the acute hospital and reduce stigma associated with mental health.
Liaison services are an essential part of the acute service drawing in the specialist expertise and facilitating collaboration within, between and beyond hospitals. Liaison service activity can contribute to new ideas and solutions on how to improve efficiency and quality of care for those with poly co-morbidities. Comprehensive assessment is an important role of the MHLS nurse with all patients receiving a biopsychosocial assessment (YIM or PSANI), a risk assessment and an opportunity to avail of a safety plan. The education of staff, supporting patients and staff, advocating for the patient, ensuring streamline onward referral, safe discharge, family liaison and outreach to other community services and mental health teams also fall within the realm of a MHLS nurse.
Are there any moments/things that you found particularly challenging and/or rewarding about your role?
Setting up any service is difficult but covid-19 created a major set back in the development of the MHLS and the increase in referrals of a mental health nature following covid has created more of a demand for MHLS provision. The current provision of the MHLS is small therefore extending the MHLS would be a fantastic development and a business case has been submitted to hopefully secure this. Another challenging aspect of the role is the potential for and the occurrence of suicide. This is always an extremely difficult experience for all involved, as a leader it is vital to manage the practical aspects of this process whilst balancing this with the wellbeing of staff and family and/or carers.
On a positive note, it is always rewarding to hear patient feedback about the MHLS. I am a very lucky manager as the team are fantastic, they are passionate about their role and ensure the patient is at the centre at all times. Positive feedback from patients, and indeed staff from other services, confirms that the service is improving experiences for patients which is extremely rewarding.
As a team we are working on a quality improvement project, in response to feedback from the public, to create a virtual library of training resources comprising of face-to-face bespoke training/information sessions, video training, drop in sessions and sources of support/education etc, with the aim of ensuring acute hospital staff feel confident and competent in dealing with mental health presentations and improving the overall experience of those experiencing mental health problems whilst an inpatient in Altnagelvin or SWAH .
How do you look after your Mental Health in the workplace?
I always try to arrive early and park far enough away from base to get a few steps in, finished off with a nice coffee to start my workday!
As a team we try and eat lunch together although this is not always possible. I believe as a leader it is important to create a positive workplace culture where staff feel valued and able to discuss any concerns or stresses so we can deal with them together.