Research in practice

How well equipped are children's nurses to deal with mental health conditions?

Literature review examines experiences of children's nurses and the impact training can have

Literature review examines experiences of children's nurses and the impact training can have

A lack of confidence in dealing with mental health issues was expressed.
Picture: Getty Images


There is evidence that one in ten CYP aged 5-16 years living in the UK has a mental health condition (Green et al 2004). More than 50% of the mental health conditions experienced by adults will have begun in children under 14 years of age (Earle 2016). If treated effectively in childhood and adolescence, the severity of the mental health conditions will be reduced, resulting in better outcomes for children and young people. Often the first contact  in health services is with children's nurses who may not have received specific and comprehensive training in mental health conditions.


The aim of this literature review was to explore the experiences of children’s nurses when caring for CYP with mental health conditions and what impact training may have on their care.


An analysis of the literature - summarised in this extended abstract - identified four themes and one sub-theme:

  • Lack of knowledge and confidence.
  • Physical needs are prioritised over emotional needs.
  • Training improves knowledge and confidence.
  • Collaborative working.
  • A sub-theme of ambiguity about the children’s nurses’ role in mental health.

In-depth analysis of these themes revealed a cyclical pattern of behaviour among children’s nurses. A lack of knowledge in mental health and how to care for mental health disorders can lead to a lack of confidence. Nurses are more likely to practise only what they are confident in, which is physical healthcare. It seems there is not enough collaborative working between nurses and other healthcare professionals and they are often unaware of each other’s roles. Some nurses were found to be unsure of their role with children and young people's mental health. This is summarised in one of the papers found in the literature review as an ‘ongoing powerlessness loop of care’ (Vallières-Noël et al 2016).


The limitations with this literature review were time and financial constraints, restricting the number of search techniques and data analysis methods used, for example grey literature was excluded from the search due to the lack of time to source and critique it. The search strategy only included searching electronic databases, and other searching techniques were not attempted. The employment of investigator triangulation would have helped increase the trustworthiness of the analysis and the credibility of the findings, providing the researchers had reached the same conclusions (Guion 2002).


Children’s nurses need to be given more thorough and effective training in mental health. There also needs to be onging education in child and adolescent mental health which should continue throughout children's nurses' careers.


Implications for practice

  • An increase in effective training will improve nurses’ practice which will improve outcomes for this population.
  • Research needs to be conducted on how the NHS can provide the resources for this extra training.
  • Further research  needs to explore the format this training will take and how it will be incorporated it into pre-registration degree programmes and registered nurses' continuing professional development.



Rachel Grieve is now a staff nurse at Leeds Children’s Hospital. This article is from her undergraduate dissertation of 2018 supervised by Melanie Robbins, nursing lecturer, University of Leeds. It was written on behalf of the RCN's Research in Child Health community

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