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640 UNIT V Middle Range Nursing Theories

support teams, and one 24-hour facility in the com- recently, projects have been established in child and
munity (Barker & Buchanan-Barker, 2005). The Tidal adolescent care in Sydney, with a new development
Model became international as interest spread in in the area of “justice health.” In New Zealand,
the United Kingdom first to Ireland, then throughout nurses at Rangipapa in Porirua were the first to
the world. introduce the Tidal Model into a forensic setting
Most of the early Tidal Model developmental work and the first to investigate the experience with the
was undertaken in the United Kingdom, with projects model from the perspective of staff and clientele
ranging across hospital and community services, (Cook, Phillips, & Sadler, 2005). The Tidal Model’s
from acute through rehabilitation, to specialist foren- emphasis on story has proven particularly attractive
sic services and community care. These ranged from to the indigenous Maori and Pacific Islands people
metropolitan services in cities like central London of New Zealand, who greatly value the power of
and Birmingham, where the clinical populations are storytelling. In Japan, the Model has been the focus
socially, culturally, and ethnically diverse, to Corn- of a major development program for almost a de-
wall, Glamorgan, and Norfolk, where people from cade at the Kanto Medical Center, the largest private
rural English and Welsh communities were served. psychiatric facility in Tokyo. Dr. Tsuyoshi Akayama,
The most extensive project was in Scotland, where the lead psychiatrist, translated the Tidal Model
since 2003 the Glasgow mental health services oper- training materials into Japanese and then taught his
ated a series of Tidal projects, embracing acute, reha- medical and nursing colleagues how to use the
bilitation, adolescent, and elder care, in what was the Model, following his short study tour in Newcastle
largest mental health service in the UK (Lafferty & with Dr. Barker. This was the first formal collabora-
Davidson, 2006). By 2012, the Glasgow projects had tion between psychiatrists and nurses—as nurses
extended to include Greenock, Inverclyde, Paisley, had led the implementation in the earlier projects.
and Ayrshire, representing more than a third of the Dr. Akayama has promoted consideration of the
overall population of Scotland. Tidal Model within the “developing nations” pro-
The Republic of Ireland established a wide range of gram of the World Psychiatric Association. The
projects in County Cork, County Mayo and Dublin, Japanese have set a trend for greater interprofes-
ranging across hospital and community settings. sional collaboration, albeit with nursing taking the
Cork City, Ireland, was the first to introduce and lead role.
develop the Tidal Model within community mental The Tidal Model of Mental Health Recovery is
health care at Tosnu—Gaelic for “fresh start.” directed toward understanding and explaining fur-
At the Royal Ottawa Mental Health Centre in ther the human condition. Central to this effort is
Canada, three programs implemented the Tidal helping people use their voices as the key instrument
Model in September 2002. The Forensic and Mood for charting their recovery from mental distress. The
programs include inpatient wards and outpatient Tidal Model is a person-centered model of mental
components. The Substance Use and Concurrent health care delivery, which is respectful of culture
Disorders Program includes an inpatient ward, out- and creed (Barker & Buchanan-Barker, 2005). This
patient nursing, a day hospital, and a residential pro- practical theory identifies the concepts necessary to
gram in the community and is the first program of its understand the human needs of people with prob-
kind to implement the Tidal Model. In February lems in living, and how and what nurses might do
2004, the Tidal Model was introduced to remaining to address those needs. The theory systematically
inpatient wards, including geriatric, crisis and evalua- explains specific phenomena and suggests the nature
tion, general psychiatry in transition, psychosocial of relationships within a particular worldview.
rehabilitation, schizophrenia, and youth (adoles- Barker, however, has consistently asserted that the
cents). Across Canada, also there has been much theory is “no more than words on paper.” It is not a
interest in the Tidal Model. It has been implemented reified work or recipe for practice, but a practical and
or is in progress in facilities from coast to coast. evolving guide for delivering collaborative, person-
In Australia, the Model was first introduced in centered, strength-based, and empowering care
Sydney followed by Townsville, Queensland. More through relationship.