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‘No health without mental health’ should be the maxim of all adult nursing students

A new University of Exeter programme gives equal priority to mental and physical health

A new University of Exeter programme gives equal priority to mental and physical health


The first intake of nursing students at the University of Exeter. Picture: UoE

The removal of training bursaries for nursing students generated much publicity. Less newsworthy, but of equal importance, was the simultaneous removal of existing controls on nursing student numbers, a policy implemented to deregulate the higher education market for nurse training.

The government wanted to enable new education providers to offer pre-registration courses for nursing students. Here at the University of Exeter, we are embracing this long-awaited opportunity.

With no history of nurse education, we started with a blank sheet of paper and set out to rewrite the nurse education playbook.

Breaking down the barrier between mental and physical health education

The UK, unique in Europe, educates nurses in separate mental and physical health silos. Our regulations force students to choose a specific field of practice from the very beginning of their nursing journey.

When designing our adult nursing programme, the University of Exeter abolished specific mental health modules of the kind common in most educational programmes, and instead developed a four-year master's programme built around six ‘pillars’. And we gave mental and physical health equal priority in our adult curriculum.

Mental health is still often relegated to the margins of a programme, such as a short placement or a special ‘theory’ module

The new Nursing and Midwifery Council standards for pre-registration education emphasise the focus that nurse educators should give to mental health. This is a welcome change, but in our view the regulator did not go far enough – it chose not to abolish the archaic division between pre-registration mental and physical health nursing education.

Despite the new standards, mental health is still often relegated to the margins of a programme, such as a short placement or a special ‘theory’ module. By embedding mental health as a core pillar of our adult nursing programme, we wanted to make the oft-used phrase ‘no health without mental health’ more than mere rhetoric.

Embedding mental health into all aspects of nurse education


Picture: iStock

We have set out to normalise conversations about mental health in adult nursing practice. Like the other five pillars in our programme – fundamental nursing care, evidence for practice, patient and public involvement, global health, leadership and management – our ‘no health without mental health’ pillar is led by a lecturer who ensures this maxim informs all lectures, simulations and placements.

Our programme encompasses the broadest spectrum of mental health problems. In their daily practice, most adult nurses are likely to encounter people who are anxious and depressed; physical and mental health difficulties are common bedfellows.

Although some of our students can go on to qualify as joint adult and mental health nurses, all of our adult nursing students learn the same proficiencies as those used by psychological well-being practitioners (PWPs) working in improving access to psychological therapies (IAPT) services.

All nursing students will have an IAPT placement in their first year. We have even employed a PWP as a lecturer-practitioner – a rare or possibly even unique move for a nursing programme.

By normalising conversations about mental health wherever people seek healthcare, our nursing students will challenge the institutional discrimination faced by people with mental health problems in physical healthcare services.

A total of 34 new students share this vision and joined us last month as the first ‘Exeter nurses’.

We are delighted to welcome them and hope they can become ambassadors for our vision of the ‘future nurse’, where nursing narratives about mental health are as routine as those about physical health.


David Richards is professor of mental health services research and head of nursing, College of Medicine and Health, University of Exeter

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