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Mature students are vital to mental health nursing – but numbers are dropping

Financial pressures and the removal of the nursing bursary are putting older potential candidates off mental health nursing as a career

Financial pressures and the removal of the nursing bursary are putting older potential candidates off mental health nursing as a career

  • Real-world experience delivers real value in the mental health nursing profession
  • Older candidates are less likely to want to accrue student debt in their middle years
  • Academics in mental health nursing are concerned that the number of mature applicants for courses is falling
The number of mature students enrolling on mental health nursing courses has declined primarily due to financial pressures
Picture: iStock

Dealing with customers’ distress when a leaky water pipe damaged their house has proved good preparation for mental health nursing, says Liam Mackie, now a second-year mental health nursing student at Abertay University, Dundee.

 useful transferrable skills from plumbing to mental healthcare
Liam Mackie

‘My years in the plumbing trade – which involved visiting people’s homes, building relationships and reassuring them their plumbing problem could soon be fixed – gave me some useful transferrable skills for mental health nursing,’ says Mr Mackie, who was drawn to the profession after hearing how much his wife enjoyed nursing.

Mr Mackie's case is just one example of where coming to nursing as a career after obtaining other skills and life experiences can provide an advantage. And people may choose to move into nursing for all kinds of reasons.

Basho Dunsford, now a rehabilitation and recovery ward staff nurse at Highgate Mental Health Centre in London, decided to take up mental health nursing ten years ago, after being beaten up and mugged. 

Mr Dunsford, a former hairdresser, says: ‘After a long, life-changing recovery from serious injury and illness, I decided to try mental health nursing, which I had always wanted to do. I became a mental healthcare assistant, which I just loved.’

Skills and qualities mature students bring to mental health nursing

Graeme Gentles came to mental health nursing through caring for his brother who has Down's syndrome
Graeme Gentles

Clearly recognising his potential nursing skills, Mr Dunsford’s local trust suggested he take up training as an assistant practitioner. That was soon followed by a further 18-month full-time course at Middlesex University, leading to his degree in mental health nursing.

Recent research on the recruitment of mature nursing students for the Office for Students shows that their interest in nursing usually stems from personal or family circumstances, as it did for Mr Dunsford, Mr Mackie and Graeme Gentles, a former joiner, now a third-year mental health nursing student at Abertay University. 

He says caring for his brother, who has Down’s syndrome, taught him ‘to look at the person, rather than their condition’.

Nurses working in higher education recognise the additional skills and qualities that mature students can bring to the profession.

Confidence, drive and focus

Middlesex University associate professor of mental health and social work Nicky Lambert describes her mature students as ‘a joy to teach’.

‘The life experience, human and communication skills, and diversity that mature students bring, to the classroom, where they enrich the learning experience, and to their vulnerable patients, is immensely valuable,’ she says.

Basho Dunsford will remain ward-based, focused on person-centred, therapeutic mental healthcare
Basho Dunsford

Abertay University lecturer in mental health nursing Judith Kelly agrees. ‘Mature mental health nursing students, who make up around one third of my classes, tend to possess a high level of emotional intelligence and resilience, so are able to take the complex challenges of difficult placements in their stride and bounce back,' she says. 

‘A workplace environment is not new to them, so most have confidence, drive and focus, and their drop-out rate is low.

'Because they bring the real world into the classroom and enrich communication, we enjoy teaching mature students and our younger students appreciate having them in the classes.’ 

For mature students with a practical background, coping with essay writing and presentations long after leaving school can be challenging. But with support, most meet the challenge head on, says Ms Kelly.  

Mr Dunsford, who says he ‘wasn’t academic at school’, found his 7,000-word university dissertation on mindfulness ‘particularly challenging’. And Mr Gentles, who was diagnosed with dyslexia while struggling on his pre-university Access to Science course, has been grateful for specialist support throughout his degree.

‘It’s made such a difference,’ he says. ‘I’m getting 'A' grades for my essays now and intend to do a master’s degree on dementia after qualification.’

Harder to retrain in mental health nursing without financial support

Unfortunately, removal of England’s student nursing bursary and its replacement with student loans in 2017 – described by the RCN as a ‘disaster’ – has significantly reduced applications from mature and male students. According to the recent Interim NHS People’s Plan, these have fallen 39% and 40% respectively.

This sudden drop has also affected the proportionally large number of mature and male students applying for mental health nursing places, according to the NHS Long Term Plan, published earlier this year. 

‘Students need time and space to study, think and grow into gifted nurses who will drive practice forward. Investment in nurse training today is investment in everyone's future health’

Nicky Lambert, associate professor of mental health and social work

The plan states: ‘Mature students are more likely to have family and other commitments that make it harder to retrain without financial support. This has particularly affected mental health and learning disability fill rates, priorities for the NHS.’ 

Indeed, the Office for Students claims that mature students are ‘more debt averse than younger students and more likely to be deterred by removal of the bursary’.

Challenges of studying for mental health nursing

Scotland has retained its nursing bursary, so Mr Mackie and Mr Gentles will benefit when their annual bursary rises to £10,000 next year. But could they have fulfilled their mental health nursing ambitions without this financial support?

Despite having a young family, Mr Gentles says that even without a bursary, his decision to study for mental health nursing would be unchanged. ‘However challenging, it is something I’m absolutely determined to do, so I would have found a way.’

Mr Dunsford, who gained his nursing degree before the bursary’s removal in England, says, ‘At my age I could never have afforded to study mental health nursing without a bursary and I’m shocked that today’s students are expected to do so.’   

Mr Mackie is unsure. ‘Without the security of a Scottish bursary, our family would have had to think extremely hard and plan ahead before I made such a life-changing career decision in my late twenties. 

‘I certainly wouldn’t want to be saddled with a student debt at this stage in my life. Even with a bursary, I and most of my nursing cohort need to work part-time as healthcare support workers with a nursing bank to supplement our incomes,’ he says. 

Sharp fall in mature nurse enrolments for mental health degree courses

Mental health nurse numbers have fallen by over 10% this decade and, although NHS Digital says there has been a small, recent increase of 209 nurses, applications from mature student remain discouraging. 

For example, mature nurse enrolments for mental health nurse degree courses at English universities have fallen from an average 74.8% between 2011 and 2017, to just 45.9% for 2017-18.

Hospital trust managers have also noticed a shifting trend in age distribution of mental health placement students. They claim that for those with a practical background, the ratio of mature to young students of 60:40 has reversed since the bursary’s removal.

University staff have reported seeing fewer mature prospective mental health nursing students at open days and selection events, with one university describing mature enrolment numbers to mental health courses as ‘falling off a cliff edge’ since tuition fees were introduced.

Ms Kelly, who taught at an English university in the years immediately before and after the introduction of student fees, is unsurprised by such findings. 

‘Before the nursing bursary was scrapped, most of our mental health nursing students were mature, but this sharply declined to just one or two a year later, which unfortunately altered our classroom dynamics. So, I returned to Scotland where we still have large numbers of mature mental health nursing students.’

Nursing students under a lot of financial pressure

The Welsh Government has continued its nursing bursary, provided those gaining a Welsh university degree work in Wales for at least two years after graduation, says University of South Wales' head of the School of Care Sciences Nicky Genders.

‘We have seen a recent increase in all mental health nursing applications – with many mature students applying from previous careers. They tell us our bursary is important to their decision, as they don’t wish to take on a long-term student debt in their middle years.’

But Professor Lambert, who says she could not have afforded nurse training without a bursary, is concerned about today’s nursing students.

‘We’ve noticed recently that our students are under a lot of financial pressure. This is worrying, as students need time and space to study, think and grow into gifted nurses who will drive practice forward. Investment in nurse training today is investment in everyone’s future health.’

For the foreseeable future, Mr Dunsford will remain ward-based, focusing on person-centred, therapeutic mental health care and patient rehabilitation. Mr Gentles, once qualified, hopes to work with people with dementia, while Mr Mackie says he may choose to help recently released prisoners with mental health issues as they adapt to community life.

According to NHS England, one in four of the general population experience mental health conditions. But in the future, will the NHS be able to attract mature, committed nurses to train as mental health nurses?

Vital to see investment in mental health nursing workforce

Unite’s lead professional officer for mental health David Munday is not optimistic. 

‘Unfortunately, our NHS staffing crisis is being prolonged as we wait for the final version of a fully costed, five-year NHS People Plan. The government should bring back undergraduate healthcare student bursaries and deliver its repeated promises, such as golden handshakes for staff working in such previously underinvested areas as mental health.’

RCN professional lead for mental health Catherine Gamble says: ‘The removal of the bursary has had a dramatic impact on all those applying to study nursing. We know this has affected mature student applications, too.
 
‘With mental health a priority, it’s vital we see investment in the nursing workforce, not only to bring more people into the profession, but to retain the skills of the existing workforce.’

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Catharine Sadler is a freelance health writer

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