Game Changers in the Treatment of and Engagement With Persons Living With Mental Health and Substance Use Disorders: The Role of the Nurse.

The game changers in mental health and substance use disorder treatment have been shaped by historical sea changes marked by transformative advancements that have significantly enhanced patient care. Breakthroughs in psychotherapy, psychosurgery and psychopharmacology have each contributed to reshaping clinical practices, especially the revolutionary discovery of psychotropics. More recently, the rapid development of artificial intelligence has begun to address long-standing barriers in access to care for individuals experiencing mental health and substance use disorders. Transitioning from past eras characterised by institutionalisation and inhumane treatment, the field of mental health and substance use has embraced a more holistic, patient-centred and community-based approach. Landmark legislation and progressive policy frameworks have played a vital role in safeguarding the rights and dignity of individuals living with mental health and substance use disorders. Patient engagement, the cornerstone of effective treatment, continues to evolve alongside the expansion of therapeutic options, from patients having no autonomy over decisions to encouraging clients to make informed decisions about their care. Within this dynamic landscape, nurses serve as essential gatekeepers of the healthcare system, providing critical functions such as clinical assessment, medication administration, patient education, counselling and ongoing monitoring to mitigate adverse treatment outcomes and support recovery, while establishing a therapeutic relationship in all aspects of care. This historical discussion paper explores and summarises the key game changer events by highlighting the treatment and engagement of persons living with mental health and substance abuse disorders of the past in timeline periods. Predictions for the future are also projected to encourage reflections of the past and thought-provoking acumens for the future.