The Department of Health’s (DH) announcement of its intention to create ‘thousands of new roles in the mental health workforce’ must be greeted with a feeling of relief and reassurance – not least for its good intention and ambition. However, many will feel unsure when applying a reality test to its plausibility.
We see and hear big numbers mentioned regularly in mental health care, usually combined with even bigger language such as growth, demand, referrals, morbidity, incidence and prevalence of disease. This is language that I have grown out of using myself, recognising that newer and better language is far less alienating and disempowering – but perhaps that is a topic for another occasion!
The big numbers brought up in relation to mental health care generally reflect what we don’t have rather than what we have, sadly.
We know that the DH report mentions £1.3bn to transform mental health services with reference to 21,000 new posts, this is to meet the need of a projected extra one million patients needing help, care and treatment by 2020/21.
I doubt very much that these 21,000 new staff will all be mental health nurses (MHN). That kind of recruitment would be unprecedented and even if they succeeded, there are still the issues of the attrition rate and ageing workforce to tackle.
The Five Year Forward View for Mental Health has been around for nearly three years now and, as national chair, it’s fair to say that very few practitioners in the Mental Health Nurse Association (MHNA) are feeling the benefit of the supposed increased priority.
Add to this low morale, stress and burnout, a shift to loans for new entrants to the profession, the ageing demographic of existing MHNs, increased administration and restricted practice driven by a rigidity in commissioning, then we have further difficulties in how the ambition of the announcement stacks up.
We must, however, try to retain a determination to respond to these plans with hope and optimism, as the alternative will simply lead to more doom and gloom and negativity, helping no one. We must protest to survive, of course, but it is equally essential to be strong in the face of pressure, challenge and adversity in order to future-proof our profession.
It is incumbent upon all MHNs and anyone else associated with mental health care – which pretty much means everyone – to greet the plans with, as I’ve said, relief and reassurance.
We need to be assertive about doing our jobs well in a positive and good-humoured way whilst keeping a strong commitment to hold commissioners and local politicians to account.
The critical elements for us all must include pride in what we do, humanist qualities in how we exercise our skills, such as empathy, and genuineness in helping those in need.
Governments come and go, and I believe they want to do the right thing, as do commissioners – I should know I was one for over 10 years! Each is operating under difficult conditions on a macro political level (read austerity).
We cannot allow this reality to distort the more pressing situation of the huge needs of vulnerable people. So step up, speak up but do great things at the same time in believing in a better future for those needing and those providing mental health care.