New skills and shifting approaches to treatment have seen a number of new career paths appear
The make-up of the mental health workforce is changing. New roles are being developed to cope with increased demand, while others are emerging to reflect a move towards offering more holistic care to patients who are struggling with their mental health.
Wellbeing practitioners, who typically support patients with low-level anxiety or depression, are being rolled out across practices in England as part of the GP contract. Primary Care Cheshire was among the first to offer this new role.
“The majority of referrals are from people who have a mental health issue. We see a lot who are bereaved and a lot are carers who are struggling with their responsibility and very often feel overwhelmed,” says Kathy Dooley, a senior wellbeing coordinator who manages a nine-member team. The new role attracts people from nursing and therapy backgrounds but it is also appealing to people with lived experience, whose value in delivering mental health services is on the rise.
Indeed, in another part of the county, Cheshire and Wirral partnership NHS foundation trust has recruited 45 volunteer lived experience connectors. These former service users are partnered with a trainee nurse associate or advanced practitioner during training to bring another perspective. “By having somebody who has lived experience, staff gain a much greater insight into what it actually means to part of the health care system,” says Gary Flockhart, associate director of nursing and therapies for mental health and learning disability services at the trust.
Physician associates (PAs) – clinicians trained to perform most of the duties typically provided by a GP, but who cannot prescribe – are now gaining a foothold in mental health services. Traditionally PAs have been attracted to primary care or emergency departments, but now the role is being tested in mental health services by the Royal College of Psychiatrists and the workforce training body, Health Education England.
Dr Arun Chidambaram is a consultant forensic psychiatrist at Mersey Care NHS foundation trust, which now employs three PAs. “It was a leap of faith when we took them on but we knew PAs could work in an acute hospital,” says Chidambaram, who is also a member of the national working party piloting PAs. “The enthusiasm and motivation they bring has been like a breath of fresh air.”
The PAs fill a skills gap in the mental health team because they are trained to manage physical health. “That means, for example, that we can avoid a trip to accident and emergency if a patient has self-harmed or has unexplained chest pain,” says Chidambaram. PAs also have the potential to take some of the workload off psychiatrists by completing mental state examinations – mood assessments that form part of a patient’s wider risk assessment. “Currently PAs are unable to section people under the Mental Health Act, but there is the possibility that they will be able to do that in the future,” he says.
New roles are also being developed across education and health as part of the government’s mental health reforms targeting children and young people.
The first education mental health practitioners, employed by mental health trusts to work with pupils and schools to improve mental health, began their one-year training this spring. This new type of specialist will have the cognitive behaviour therapy skills needed to work with individual young people, but also help teachers recognise mental health problems in pupils.
Northampton is one of the first universities to deliver education mental health practitioner training; its first cohort of 30 students included teachers, health care assistants and psychology graduates. “It’s an exciting time because for the first time the training brings together psychological therapies and education,” says Jynna Yarrum, a lecturer in psychological therapies at the University of Northampton. “Children and adolescent mental health practitioners say when they turn up at schools teachers are just crying out for help and support – these new recruits are going to be invaluable.”
Experience: ‘My life skills have made a difference’
Career changer Graeme Gentles shares why he gave up his job as a joiner to train as a mental health nurse
I left school just before I was 16 with no qualifications and went on to a further education college in Perth to complete an apprenticeship in joinery. My granny was a nurse auxiliary and I remember on a Sunday when she was at Perth Royal Infirmary going to meet her after work and she would tell me how busy she had been.
When I was 35 I’d worked for a company for a while and when the owner retired I worked for other companies but didn’t feel the same about joinery. I always had a niggle, an urge, to be a nurse so I decided to leave work and go back to college to do my standard grades.
I then got on to an access course that gave me the higher qualifications I needed to get into nursing and I took up a place at Abertay University in Dundee.
I’ve always been interested in mental health nursing – especially the care of people with dementia. It’s very rewarding getting a smile from somebody with dementia – it gives you such a sense of achievement.
My first year at university was tricky but not as hard as I thought it would be. It was the first time in my life that I had ever done proper essays and the first time I got an A-plus I couldn’t believe it; I thought as a student I’d just scrape through. I think the biggest reward so far is probably getting really good feedback from senior charge nurses and managers on my placements – people who have been nursing for maybe 20 years who tell me I am going to make a fantastic nurse. I am just amazed.
I’m not the oldest on the mental health nursing course – I’m 40 and about seven are roughly the same age or older. I think as an older person I bring life skills with me and I think that has made a difference on my placements.
Source: The Guardian