Do we need to / can we 'cancel' Mental Health Nursing / Psychiatric Nursing?

Ever since August 15th 1977 (and prior to starting in the NHS), I've been acutely aware of the politics of my chosen career choice. Once again this explains my focus here since April 2006 and prior...

Make no mistake, starting as a Nursing Assistant at Winwick hospital, a Victorian asylum then two months later entering Warrington School of Nursing was a test. Quickly, you were preoccupied with trying to innovate and move beyond task oriented care, ritualised practice, trying to escape (the irony) from custodial care - despite the clink of keys (even on non-secure wards/clinical areas).

The quality of debate on Twi/X regards psychiatry is saddening.

The structure and domains of Hodges' model have been applied to the following editorial:

Wand, T. (2024), We have to cancel psychiatric nursing and forge a new way forward. Int J Mental Health Nurs. https://doi.org/10.1111/inm.13301

Individual
   |

      INTERPERSONAL    :     SCIENCES               

HUMANISTIC  --------------------------------------  MECHANISTIC      

 SOCIOLOGY  :   POLITICAL 

|

Group

MIND Evidence-base?           neuro- Person - identity Yes, how do we conceptualise ... "Mental health nurse" (Long-term) "Psychiatric Nurse" (Crisis) What's in a Title: REGISTERED Nurse Mental illness nurse ENOUGH! Let's Fully integrate MIND-BODY! You/We must manage legacy Recognition of emotional intelligence, rapport-empathy; people who want to 'help' others Lived experience: Care in Community Contrast with 'pastoral care'? Counselling - pre-'therapist'? RMN, RNMH .. 1. Subservient to Medicine?* Use of power, pharmacology, beds - 'controlled' environment, place of safety, restraint, loss of freedoms .. 2. Therapeutic agents - therapist? (Never truly realised: Psychology - scope of practice, Banding, Career pathways). Conscientious objection.  VALUE - VALUES Diagnosis here?  Respond to distress ? - OR

BODY -biogenic         Evidence-base? Iatrogenesis DEFINE^: 'sustainable' in terms of: individual - population NHS Professions Demographics (time-scales) Environment Economic Ethics - Human Rights Curricula medical model bio-psycho-social model ... [ ^Research ] Modalities of care - student experience/placement has changed Nurse education - curricula What would a properly funded NHS/Mental health services 'look' like?   Models  of care DEBATE ongoing: Anti-psychiatry PSYCHIATRIC DIAGNOSIS biomarkers, genetics, neurological explanations - pathologising, safety of anti-psychotics, long-term use ... Demographics - workforce scope Diagnosis here?

Where - psycho-SOCIALLY has policy been thus far? Wither humanism? Therapeutic relationship - human connection Social history: Creation of asylums to standardise care for the insane Anti-psychiatry: Psychiatry as MECHANISTIC social control Role of language, history, expections, social justice, law-public safety ...  (can you 'cancel' here?) Lived experience, family, carers, peer support workers "Lifestyle Medicine" (Map the 6 pillars to Hodges' model) Social prescribing (research?) Attitudes, Stigma, Social media Sense-making, 'Faith' 1:Pop. Social care, community resources Integrated & Person-centred care Other models of MH care/services

- mechanistically assess risk?  Formal distinction (break): MH Nursing <-> Trad. Psychiatric family? POLICY: Community care set in aspic, NHS also: funding £££££? Innovation in POLICY? No slack resource - HOW to shift to prevention/education Sustainable health care What crises are you (health professions) responding to? Determinants of health:  social, commercial, economic, social, political, education ... Mental Health Law: inc. Consent, MH Capacity (now also a 'football'?) UNHCHR - Mental Health: ‘Mental health, human rights and legislation’ (World Health Organization and the United Nations, 2023) Former: RCP Reports on CPNs* National Reports: Suicides, Homicides, Forensic, Prisons Change [Progress!]: predicated upon research & evidence, not 'rebellion' as befits a profession - Duty of care?

Once you start to apply Hodges' model then additional content often presents itself. For example, (12th March) apart from people employed in tax and undertakers how many professions, would admit to a value system that aims for, seeks making the collective enterprise redundant? A utopic appeal no doubt, and this would for a population demand that the socio-political foundation (ills!) for our individual lives are finally addressed. What are referred to as the determinants of health. It is a sign of the times that trying to do a search on this, 'redundancy' / redundant is taken as related to the state of being employed, not an ideal.

If this sounds like pie-in-the-sky, consider the birth of social medicine - the NHS. Consider too the future of the NHS and we arrive at sustainable health care systems?

National Confidential Inquiry into Suicide and Safety in Mental Health
The University of Manchester - https://sites.manchester.ac.uk/ncish/

Homicide in England and Wales: year ending March 2023 -

https://www.ons.gov.uk/peoplepopulationandcommunity/crimeandjustice/articles/homicideinenglandandwales/yearendingmarch2023