Hi all 

The Chief Nursing Officer's Review of Mental Health Nursing was published
today. See below for a summary.  The full document and and associated papers
can be downloaded from: http://www.dh.gov.uk/cno

Best wishes, 
Jill 

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Summary

1 Mental health nurses (MHNs) are the largest profession working in mental
health today. They make a vital contribution to providing care to service
users of all age groups and in all settings. If we are to improve the
outcomes and experiences of service users it is essential to strengthen and
develop mental health nursing so that it is prepared for the future.

2 The Chief Nursing Officer (CNO) carried out this review in order to answer
the question ‘How can mental health nursing best contribute to the care of
service users in the future?’ We know that nurses work as part of a team
with other professionals, so this report aims to be consistent with reviews
by other professional groups working in mental health that are also looking
at their future roles.

3 From values to action makes a number of recommendations for good practice
that apply to services across the whole age range. They focus on nursing
practice education and the organisational context in which care is provided.
4 The Healthcare Commission considers this report an important contribution
to modernising and improving the quality and care for service users. Many of
the recommendations identified in this document relate to areas outlined in
the core and developmental standards published by the Department of Health
in Standards for Better Health (DH, 2004a).

5 The recommendations in From values to action are strongly influenced by an
extensive consultation with large numbers of MHNs, service users, other
individuals and organisations. The consultation received more than 300
written responses. Responses overwhelmingly supported the need to develop
mental health nursing, focusing on its values, the need for holistic
practice and building an infrastructure that will support new developments.

6 The CNO review included an extensive literature review, which identified
that service users and carers want MHNs to have positive human qualities, as
well as a range of technical knowledge and skills. Research shows that MHNs
have the potential to use a range of evidence-based interventions, but that
further development is needed for these skills to be routinely used in practice.

7 The recommendations included in this review show what needs to be done to
develop the mental health nursing profession over the next 10 years. A
research evaluation project will identify progress and ways in
which successful implementation can happen. It is anticipated that
stakeholder organisations that contributed to From values to action will
together review developments to date during 2008.

8 Other e-publications are available to support implementation of the
recommendations in this review:
• Self-assessment toolkit.
• Best practice competencies and capabilities for pre-registration mental
health nurses.
• Recruitment and retention of mental health nurses: Good practice guide.

9. Putting values into practice
• Mental health nursing should incorporate the broad principles of the
Recovery Approach into every aspect of their practice. This means working
towards aims that are meaningful to service users, being positive about
change and promoting social inclusion for mental health users and carers.
These principles need to be reflected in training for nursing and in
organisational policies.
• All MHNs need to do what they can so that all groups in society receive an
equitable service and that the people working in mental health nursing
reflect local population groups.

10 Improving outcomes for service users
• Developing and sustaining positive therapeutic relationships with service
users, their families and/or carers should form the basis of all care.
• Mental health nursing should take a holistic approach, seeing service
users as whole people and taking into account their physical, psychological,
social and spiritual needs. This means that MHNs need to widen their skills
to improve service users’ physical well-being through better assessment and
health promotion activities and provide more evidence-based psychological
therapies. MHNs need training, supervision and managerial support.
• Inpatient care should be improved through measures that include increasing
the time MHNs spend in direct clinical contact, reviewing support workers’
roles and minimising the time MHNs spend on administrative tasks. Modern
Matrons should lead on ensuring that all are treated with dignity and
respect. 
• MHNs need to be well trained in risk assessment and management. They
should work closely with service users and others to develop realistic
individual care plans.

11 A positive, modern profession
• MHNs should use their valuable skills in the most effective way possible,
by focusing on working directly with people with high levels of need and
supporting other workers to meet less complex needs.
• Pre-registration training courses should be reviewed to ensure that
essential competencies are gained by the point of registration.
Relationships between higher education institutions and service
providers should be strengthened.
• Career structures for MHNs should be reviewed according to local needs,
and a range of new nursing roles should be developed and supported by
provider organisations.
• The recruitment and retention of MHNs need to be improved through
initiatives such as linking with schools and colleges, presenting positive
messages about mental health to the media and reviewing current roles.