Newly qualified nurses

Mental health nursing: ‘The accumulation of marginal gains’

Results in mental health care can be slow but the rewards are vast, especially for nurses with the right qualities, says Ian Hulatt.

Results in mental health care can be slow but the rewards are vast, especially for nurses with the right qualities, says Ian Hulatt

Gains in mental health come from engaging with someone and building
a relationship based on trust. Picture: iStock

If you’re attracted to a job in a high-tech environment, surrounded by machinery, flashing lights and lots of medical drama, look away now, as this article is not for you. 

I am going to ask you to consider mental health nursing: an area characterised by a focus on interpersonal relationships and the use of personal qualities and knowledge to help people during their most desperate times. 

Sometimes the pace of work can seem slow and frustrating, but just as it takes many years for an early event to make itself known as a period of mental distress, so the help you offer can be slow to have an effect. 

Widening scope

Someone far wiser than me once described mental health nursing as ‘the accumulation of marginal gains’. So what does that look like?

Mental health nursing is so diverse, and involves working with people of many different ages, backgrounds and needs. However, the small gains you accrue will always start with you engaging with someone and building a relationship based on trust. This is highly skilled work and can be difficult to achieve with anyone who is suspicious of you or has been harmed by others or themselves. 

You will need to be determined to see beyond the distress and uncover the person beneath. If your image of mental health care involves the large institutions of the past, you need to be aware that roughly two thirds of all mental health nurses work in services in the community. This can be with a wide range of people, such as young people, those with substance use issues, or those who are recovering from earlier episodes of illness.

The scope of mental health services is widening and the focus on prevention sees nurses working with people much earlier, intervening to lessen the challenges they face with a first episode of illness, and maintaining contact with them to ensure they stay well.

Patient, persistent and determined

Yet, it’s not just the people we work with directly who have been identified as needing services; there are also family members to support through challenging times. This can involve parents, but there are also siblings and others to support and inform. 

Mental health nursing has seen many changes over recent years, not only in where we work but in the help we offer. Medication still plays an important part, but there is a wide range of helpful interventions that you and professionals from other disciplines will bring to a situation.

Despite the progress made, we still do not work in a field of health where we hear the word ‘cure’, so we need to be patient, persistent and determined if we are to assist and support people who are often anxious and vulnerable. 

This field is definitely not high-tech, but if you have patience, kindness and intelligence, it may be for you. 

About the author 




Ian Hulatt is consultant editor of Mental Health Practice and RCN professional lead for mental health


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