News

When the last review of mental health nursing was carried out 10 years ago, nurses felt their contributions had been ignored.

Despite this, last week's announcement by chief nursing officer Chris Beasley of a review has been met with enthusiasm. And nurses and service users have every reason to be confident that this one will be more influential than its predecessor.

The Department of Health review is seen by many as long overdue and recent and imminent legislation - not least the Children Act 2004, the draft Mental Health Bill and the public health white paper - mean it is also imperative.

Rapid change in the way services are delivered in the past seven years, including the creation of crisis resolution teams and assertive outreach, set out in the national service framework, has increased opportunities for mental health nurses.

Although these are viewed positively, the pace of change has had several consequences. Among these are a confusion about the role of the mental health nurse and an exodus of the most experienced nurses from the acute sector. As a result, there appears to be an identity crisis about what it means to be a mental health nurse.

"The context in which mental health nurses work has changed in recent years as a result of government reforms, lessons from serious incidents and new professional roles that have grown across the health and social care system," Beasley says.

The tight, nine-month timescale for completion of the review is a clear indicator of the renewed push to define what mental health nursing should cover.

Welcoming the review, professional officer at the Mental Health Nurses Association Brian Rogers says: "We really need a steer about the way mental health nursing is going. We really need to look at what it is we should be doing and what we should not be doing."

He adds that a clear statement and set of principles about what the job involves is needed so that mental health nursing can remain a distinct branch within the family of nursing.

The specific focus in the review on the contribution of mental health nursing to child protection is one example of how new pressures could shape the identity of the mental health nurse role.

Rogers says that the attention given to this issue has been lacking in the past. "The significance of child protection has been largely underestimated. Many people working in health - not just nurses - have not really got a handle on the real impact of a parent's mental health problem on their child," he says.

Over the years, child death inquiries have found shortcomings in the way health professionals manage child protection responsibilities. But there is little evidence that these findings have translated into improvements in practice.

But the introduction of statutory duties on professionals to safeguard children and promote their well-being set out in the Children Act 2004 has increased the pressure to improve performance in this area.

Greater clarity over the approved mental health practitioner role, outlined in the draft Mental Health Bill as a replacement for the approved social worker role, is also likely to be part of the review.

Rogers says opinion is divided in the nursing world as to whether the new role is a desirable job. But it looks set to appear in the final version of the bill despite any opposition. As the newest addition to the roles mental health nurses can fill, it is therefore essential that those in the field are clear about what it involves. Ultimately, failure to do this will result in mental health service users losing out, as well as the nurses.