Introduction: mental health nursing past, present, and future

Abstract

Abstract Mental health problems and disorders account for 13% of the burden of disease across the world, and in high income countries the estimate increases to 23%, with such problems and disorders being the most common cause of disability and premature death (World Health Organization [WHO] 2004). Since the publication of Mental Health: New Understanding, New Hope (WHO 2001a), there have been concerted efforts internationally to promote mental health, reduce the burden of mental health problems, and increase the social inclusion (see Chapter 9) of people living with such problems (WHO 2001b). In the UK, since the 1999 National Service Framework (NSF) for Mental Health (Department of Health [DH] 1999) and other NSFs (DH 2001, DH/Department for Education and Skills 2004), mental health has become one of the government’s national health priorities (DH 2004b, 2006d). Within UK NHS mental health services, mental health nurses (MHNs) make up the largest proportion of the professional work- force, making them pivotal to the delivery of the NSF. Mental health nursing takes place in an increasingly wide variety of prac- tice contexts, and rapid developments in mental health and social care policy, research, and service delivery within the past ten years have impacted significantly upon the work of MHNs. There has been an increased emphasis on partnership working with service users and carers (NHS Executive 2000). The patient choice agenda is now central to service and care delivery (Care Services Improvement Partnership/National Institute of Mental Health in England 2005), and new roles, new ways of working, and new types of service have prolifer- ated (DH 2003a–c, 2005b). Staffing challenges within mental health services, together with further opportunities to extend nursing roles, raise important issues as to the most effective use of the resource of MHNs (DH 2006a, Sainsbury Centre for Mental Health [SCMH] 2005).