'Walk-ins': developing a nursing role to manage unscheduled presentations to a community mental health clinic

This paper reports on the evolution of the role of a 'walk-in' nurse at an Australian urban community mental health clinic. Despite the lack of any indication that a walk-in service was available, people persisted in presenting to the community mental health clinic requesting immediate help. A nursing position was therefore established to assess people presenting as walk-ins and address the issues identified. Data was collected over a 33 week period. Many people presented with social issues, and about half were referred to agencies outside the mental health system. A number of difficulties in the nursing role were identified including the variable workload, problems obtaining adequate clinical supervision, and lack of clarity about the place of the service within the established pathways to care. With further development, the mental health walk-in clinic role would be suitable for a nurse practitioner. Our study suggested that a walk-in clinic is preferred by many consumers, is efficient in terms of staff time, and is able to provide a high quality service responding to a wide range of presenting problems.