VOL: 99, ISSUE: 09, PAGE NO: 45
Chris Hart, MA, RMN, RGN, is nurse consultant and principal lecturer, South West London and St George's Mental Health NHS Trust and Kingston University and St George's Hospital Medical SchoolMental health nurses in the UK came through the latter stages of the 20th century with services savaged and little idea of how they would be redesigned. Nurses were not trained to do the work that was expected of them. Preregistration education was damaged and, despite welcome reform, has yet to recover.
Mental health nurses in the UK came through the latter stages of the 20th century with services savaged and little idea of how they would be redesigned. Nurses were not trained to do the work that was expected of them. Preregistration education was damaged and, despite welcome reform, has yet to recover.
Yet there were significant exceptions. The Thorn Programme and other postregistration education courses were established. Clinical approaches such as psychosocial interventions were developed, while advocates of an empathic, patient-centred approach would not be silenced. Innovative community practice actually flourished as did user involvement.
Now we are told we are going to be allowed to 'bed in' the range of clinical, strategic and staffing policies, guidelines from NICE and work coming out of the NIMHE that could transform both mental health and nursing for the better. Meanwhile, waiting in the wings is the draft Mental Health Bill and proposals that could end specialist mental health nurse training.
The highly centralist, 'top down' approach to policy disenfranchises staff and distorts local priorities and autonomy. We have to be confident enough to oppose anything that will further damage our service, our work and the lives of our patients. This requires a fundamental change in our attitude. It involves:
- Engaging in the political and ideological process of mental health nursing;
- Utilising the modern communications revolution to exchange ideas;
- Utilising newer structures and alliances, for example, the service-user movement;
- Campaigning for educational reform, including leadership and professional development;
- Campaigning for staffing levels to accommodate the needs of the patient group;
- Fundamental reform of the management structures and process that enables shared governance.
If we support the more positive strand of the government's policy strategy, we can recover the best of our nursing goals within a model that tolerates our differences and celebrates our collective identity. Then we have a future that is ours.