The slow death of psychiatric nursing: what next?

Abstract

Nursing has always struggled for recognition and status, and there has always been exploitation and shortages, and no more so than in psychiatric settings. Today, however, nursing is in truly dire straits and, as a consequence, psychiatric nursing is more precariously positioned than ever. In order to think constructively about psychiatric nursing's future, it is crucial that this wider context in which it operates is fully appreciated, and this paper begins by summarizing the key features of this context from an international perspective. It is argued that dramatic changes occurring in 'Western' societies call for radical changes in public and professional thinking, and in their vision for health care in the future. Beginning with the general nursing context, this paper depicts the perilous state of psychiatric nursing and mental health care in Australia and elsewhere, and suggests some of the causal factors. It concludes by arguing that the future mental health workforce should be a graduate specialist who stands outside existing disciplinary identities.

More Satisfying Than Factory Work: An Analysis of Mental Health Nursing Using a Print Media Archive

“…I seemed to serve as a reminder of another time. Holmes (2006) has argued that comprehensive nurse education has meant that "professional extinction is already underway" (p. 408) for mental health nursing in Australia. The indicators that it has been destructive have been hung on two issues: the demand for mental health nurses to work in mental health settings does not match the supply (Roche & Duffield, 2007;Warelow & Edward, 2009;Happell & McAllister, 2014a;Happell, 2015) and a limited interest in student nurses to undertake mental health nursing because of their negative opinions towards it (Happell, 1999;Wynaden, Orb, McGowan, & Downie, 2000;Happell et al, 2008;Happell & Gaskin, 2013;Happell & McAllister, 2014b;Happell et al 2014).…”

Utilization of Standardized Patients to Decrease Nursing Student Anxiety

“…If students feel less anxious, they may be more likely to establish an enhanced therapeutic relationship with the patient thus achieving the goals of improving patient outcomes and compliance with treatment. Additionally, there is a current and projected shortage of psychiatric mental health nurses, and numerous studies indicate that student anxiety surrounding mental illness leads to negative stereotypes of the mentally ill and less interest in pursuing mental health nursing as a future career (Holmes, 2006;Happell, et al, 2014;Happell & Gaskin, 2012;Happell & Gough, 2009). Incorporation of SP simulation experiences into the mental health nursing course may be one method of enhancing student confidence and recruiting RNs into this specialty.…”

Becoming a Psychiatric/Mental Health Nurse in the UK: A Qualitative Study Exploring Processes of Identity Formation

“…Many others are likely to work in the highly generic role of case manager, which forms the mainstay of community care and is typically open to any of the core professions (King et al, 2002). Some commentators such as Holmes (2006) have argued that in the face of chronic shortages, the demoralisation of care providers across all traditional professions, and accounts of the mental health system in most English-speaking countries being in crisis, the best solution (albeit one that is likely to be opposed by the professions themselves) would be to adopt a post-disciplinary stance and develop a generic mental health practitioner specialty. Identity discussions inevitably involve complex social forces (Foucault, 1988).…”