UK ministers must set out how to recruit and retain thousands more mental health nurses to plug the profession’s biggest staff shortage, healthcare leaders are warning.
Mental health nurses account for nearly a third of all nursing vacancies across England, resulting in overstretched services that are struggling to deliver timely care, according to research carried out by the NHS Confederation’s mental health network.
Sean Duggan, the network’s chief executive, said: “Mental health leaders and their teams are pulling out all the stops in what are very constrained circumstances, but they cannot be expected to solve this staffing crisis alone.
“The knock-on effect means that the mental health crisis the nation is facing will in turn become a crisis for the whole healthcare system and the country. This relentless pressure on mental health staff cannot be allowed to continue with the ultimate impact being on the patients who most need that care.”
He urged the government to provide a “clear and firm commitment” that mental health nurses will be equally prioritised alongside general nursing in the forthcoming workforce plan.
Duggan said this should challenge the “false stereotypes that exist about mental health nursing as a career and move the dial in terms of public perception as to what working in mental health in 21st century looks like”, which includes a wide range of roles in psychiatric units as well as working with patients in the community.
NHS Confederation analysis carried out by the Nuffield Trust found that almost one in five mental health nursing posts were vacant.
The report calls for strong direction from government and dedicated investment to reflect the fact that the 11% increase in mental health nurse numbers since 2015 is half that in adult and children’s nursing.
The research also identified significant regional differences. For example, there are 63% more mental health nurses per capita in the north-east and Yorkshire (91 among 100,000 people) than in the east of England (56), after adjusting for need.
The profession also faces a demographic timebomb. The data shows that more than half of mental health nurses are aged 45 and over, with one in five aged 55 and over, and a higher proportion of nurses in mental health services are approaching pensionable age compared with those in acute services. The status of “mental health officer”, which is held by many nurses who started working in the NHS before 1995, means they are eligible for retirement at the age of 55.
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The report warns there are significant cultural barriers to recruiting mental health nurses, with a “One Flew Over the Cuckoo’s Nest stigma” attached to these roles, in reference to the 1975 film that takes a critical look at the 1960s psychiatric system.
There are also retention problems, with high dropout rates during training and early career, despite the fact that mental health nursing offers better progression opportunities, including a higher proportion of staff on the top pay bands. The Nuffield Trust estimates that about one in seven students who start a pre-registration course in mental health nursing will not graduate.
A Department of Health and Social Care spokesperson said: “We are expanding NHS mental health services and attracting, training and retaining the workforce – with the number of mental health nurses working in NHS trusts increasing by over 1,000 in the past year. We’re also investing £2.3bn of extra funding a year in expanding and transforming mental health services in England by March 2024, so an extra 2 million people can be treated.”
