The more things change the more they stay the same? Staffing in mental health services
Mental health nursing staff shortages have been recognised for a very long time. However, despite recent increases in student numbers and an increase in 3000 nurses employed in England’s NHS since the low point of 2017, the numbers of mental health nurses only now almost reach the level of 10 years ago, with vacancy levels varying vary from 11.4% in North-East and Yorkshire, to an eye watering 20.3% in the South-East. Some new roles have been introduced, such as the nursing associate, although are not yet robustly evaluated. Trusts have been exhorted to offer flexibility and reduce early retirement. These interventions are probably helpful, but insufficient in the context of national plans for increased nursing numbers.
It is a truism that for every complex human problem there is a solution that is simple, plausible and wrong and staffing issues are certainly affected by a myriad social, professional, financial, demographic, political and psychological factors. If, as seems likely, the numbers of new nurses being sought for ambitious workforce plans may never be met in the context of an ever-increasing demands on mental health services, then what can be done?
Firstly, the political and professional pressure for growth in mental health services to provide individual interventions to ever larger parts of the population should be recognized, at least partially, as being a result of societal factors. As such greater emphasis should be given to addressing attitudes and culture in society that feeds distress, combined with public health level interventions, backed up by rigorous programmes of research.
Secondly, a more radical review of the future of the workforce is needed. Surely it is time for all professions, including nursing, with the critical engagement of service users, to review their roles and challenge profession-centric ideas as to what might constitute their unique contributions. Plainly we cannot continue doing what we have always done in a world that is constantly changing and creating new demands.