Mental health deserves better: Resisting the dilution of specialist pre‐registration mental health nurse education in the United Kingdom

Abstract

This article aims to draw attention to increasing genericism in nurse education in the United Kingdom, which sees less specialist mental health education for mental health nursing students and offers opposition to such direction. In 2018, the Nursing and Midwifery Council produced the ‘Future Nurse’ standards which directed changes to pre‐registration nurse education. This led to dissatisfaction from many mental health nurses, specifically regarding reduced mental health content for students studying mental health nursing. Concerns have been raised through public forum and evolved into a grassroots national movement ‘Mental Health Deserves Better’ (#MHDeservesBetter). This is a position paper which presents the perspective of many mental health nurse academics working at universities within the United Kingdom. Mental health nurse academics collaborated to develop ideas and articulate arguments and perspectives which present a strong position on the requirement for specialist pre‐registration mental health nurse education. The key themes explored are; a conflict of ideologies in nursing, no parity of esteem, physical health care needs to be contextualized, the unique nature of mental health nursing, ethical tensions and values conflict, implications for practice, necessary improvements overlooked and the dangers of honesty and academic ‘freedom’. The paper concludes by asserting a strong position on the need for a change of direction away from genericism and calls on mental health nurses to rise from the ashes to advocate for a quality education necessary to ensure quality care delivery. The quality of mental health care provided by mental health nurses has many influences, yet the foundation offered through pre‐registration education is one of the most valuable. If the education of mental health nurses does not attend to the distinct and unique role of the mental health nurse, standards of mental health care may diminish without assertive action from mental health nurses and allies.

Mental health nurses may require ongoing learning and training in physical healthcare throughout their career

“…However, they problematise the health outcome inequities among people with severe mental illness as primarily an issue for mental health nursing. While mental health and physical health are inextricably linked, there is considerable opposition among mental health nurses to an ever-increasing focus on physical healthcare skills which, surely, cannot be achieved without reducing attention to other key relational skills 6…”

What is the purpose of nurse education (and what should it be)?

“…Calls for transgression are, in part, a predictable response to the intensification of manualisation. As space for critical thinking, creativity and dissent is squeezed out, frustration is inevitable, particularly for nurses operating in the academy (Warrender et al, 2023). This is compounded by the performativity of regulatory statements.…”

Standards of proficiency for registered nurses—To what end? A critical analysis of contemporary mental health nursing within the United Kingdom context

“…Addressing these criticisms, the Future Nurse Standards appear to have formulated proficiencies that are all-encompassing, with a view to ensuring that all nurses, irrespective of field specialism, attend to the physical and mental health needs of patients. While well intended, this could also be partly responsible for the dilution of mental health nursing within nurse education generally (Warrender et al, 2023). It contributes to ambiguity about how to align curriculum, pedagogy and assessment in developing the specific sorts of ethical reasoning and critical thinking that mental health nurses require in mental health-specific contexts.…”

“…The Australian model has also been found to contribute to high attrition rates of staff working within inpatient settings, as well as skills deficits, and overall poor mental health care (McKeown, 2023a). Even though UK field specialist nurse education gives the impression of a fundamentally different model to that of Australia, existing evidence shows an erosion of specialist mental health nurse education at the undergraduate level (Haslam, 2023; Warrender et al, 2023). Lack of preparedness for mental health nurses within the context of developing critical thinkers and evidenced‐based practitioners might perhaps explain existing defensive practices where staff are managing their cognitive and emotional dissonance by attending to bureaucracy activities (McKeown et al, 2020)—as opposed to addressing the gap of delivering evidence‐based psychological therapies in inpatient mental health settings (Berry, Raphael, Haddock, et al, 2022; Berry, Raphael, Wilson, et al, 2022).…”