RMN - Registered Mental Health Nurse Career Guide

Why do people choose to become a Mental Health Nurse?

The number of Mental Health Nurses in the UK decreased by around 6000 between 2009 and 2019 , with a reported 2000 per month leaving their mental health nurse jobs in 2018.

Further, a report by the NHS in 2018 found that 20% of all of the vacant nursing positions within the NHS were in Mental Health Nursing.

Meanwhile, hospital capacity for mental health patients has shrunk by 30% since 2009.

Broadly, it’s a similar picture to the rest of the NHS: increased patient demand colliding with decreased funding. After all, some 1 in 4 people in the UK now suffer from a mental health problem, and some of the stigma attached to confronting those issues is starting to dissipate.

However, thousands of RMNs continue to enter the workforce and start their mental health nurse career every year and the Government is on an agenda to create 21,000 new mental health nurse jobs by 2021.

In addition to this more positive news, there are a range of factors that attract the right people to Mental Health Nursing that ensure it remains a fascinating and attractive career. Perhaps most significantly and obviously, it’s a uniquely challenging, and therefore rewarding, role.

Multiple patients with physical issues are typically treated in the same way; mental health patients with the same diagnosis will all require a completely different approach. Nurses are problem solvers – but for Mental Health Nurses, the problems are distinctly complex.

As a result, making a difference in mental health – even in the smallest way – offers incredible job satisfaction. You’ll also really get to know patients in a way that a General Nurse simply couldn’t. Your job demands going deeper, building trust, making your patients feel safe, and establishing long-term relationships.

Other positives are numerous. There is no typical day as a Mental Health Nurse – so it’s very difficult to get bored. You have great flexibility over when you work and where you work, with a variety of care settings like prisons and psychiatric wards eager for your skills. It’s also an excellent platform to build a more specialised career as a counsellor or therapist.

This guide is an exhaustive collection of advice, articles, videos and opinions on everything that matters to Mental Health Nurses. So, whether you’re new to the field or a seasoned professional, we’ve got your interests covered.

The Nurses.co.uk Mental Health Nursing Survey

What is the public’s perception of your job as a Mental Health Nurse? Access the results of our research to find out

What does the public think of Mental Health Nursing? We surveyed RMNs & the public and discovered a disconnect in how Mental Health services are perceived.

Public awareness is improving - but RMNs need more support

Do you face stigma as a Mental Health Nurse?

We spoke to Mental Health Nurses to learn more about their challenges and to the public to find out how they feel about Mental Health Nursing.

The results may well surprise you.

  • - Mental Health Nurses experience stigma and belittling attitudes
  • - Mental Health Nurses don’t feel appreciated by local authorities
  • - Many feel that Mental Health is still poorly understood

Whilst we could see that the perception of the public remains a concern to Nurses, especially as it relates to what it is that Nurses actually do, it seems that efforts to raise awareness of Mental Health issues are paying off.

The public were generally supportive of the psychiatric Nursing profession, despite Nurses reporting high levels of stigma. However, more needs to be done to support front line Mental Health professionals.

Of even more serious concern are issues relating to staff shortages and increased demand which many Nurses said affect their ability to provide adequate Nursing care to patients.

Find out what else we learned!

Send me a link to the Mental Health Nursing Survey results

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Nurses share their feelings on the challenges facing those who work in Mental Health

NHS Nurses have been hit by well-publicised shortages over recent years, but most evidence suggests that Mental Health Nursing has been hit the hardest. In September 2018, it was reported that around 2000 Mental Health Nurses were quitting the NHS every month – an unsustainably high figure. So, what’s behind the exodus? And why is mental Health Nursing currently so challenging?

First and foremost, the issue of under-staffing has a cyclical effect. Recruitment and retention problems have heightened workloads and work-related stress, and these factors have, in turn, impacted recruitment and retention.

Meanwhile, as our own survey supports, there is a stigma attached to Mental Health Nursing. And that stigma isn’t helped by a growing fear of assault – with attacks growing by 21% in recent years.

There is also a feeling among Mental Health Nurses that the pressures of the job just aren’t sufficiently understood or accounted for – let alone remunerated. The emotional impact is unimaginable, and with resources overstretched, not enough is being done to protect and support them.

But ultimately, the only meaningful answers to this question come from Mental Health Nurses themselves. We work with a number of brilliant RMNs who are kind enough to share their takes on what the challenges are – and below we’ve shared some of the most powerful and inspirational.

What does a Mental Health Nurse actually do?

Getting to grips with what Mental Health Nurses actually do is, in many ways, far more challenging than outlining the responsibilities of a Children’s or Adult Nurse. Fundamentally, this comes back to the foundations of what Mental Health Nursing is: every day is drastically different, because the approach required for every patient is distinct.

There are, however, some useful generalisations about the daily experiences of the approximately 35,000 Mental Health Nurses currently working in the NHS.

Many newly qualified RMNs start work in acute care settings. There, they work with patients detained under the Mental Health Act, protecting the patient’s rights, engaging with their family and friends, and developing a package of care.

“Mental Health Nurses have worked within the community for many years following the mass closure of psychiatric “asylums” in the 1970’s and 80s, however it is perhaps now more than ever that RMNs (Registered Mental Health Nurses) are provided with career opportunities and pathways which do not involve working in a hospital at all.” - Laura Woods, read her article about Community Mental Health Nursing here

On wards, a huge part of the job is actually liaising with community mental health teams, carefully planning accommodation and support for when the patient is discharged. Without question, this will be a key feature of many Mental Health roles; how a patient can safely and sustainably return to their lives.

Mental Health Nurses will quickly become specialised, perhaps choosing to work with older people, men or women. And the locations can vary greatly too, from Psychiatric Intensive Care Units and Police Assessment Suites to prisons and care homes.

With all this in mind, defining duties is virtually impossible. To get a real sense of what Mental Health Nurses do, you need an inside look at the profession. So we’ve shared some of the most popular articles and videos from our RMNs that shed light on the fascinatingly diverse world of Mental Health Nursing.

What’s the history of Mental Health Nursing in the UK?

The early history of Mental Health Nursing in the UK is, for the most part, just as bleak as you might imagine. If we start in 1774 with the so-called Madhouses Act, which was the very first legislation introduced in the UK that addressed mental health, we arrive in a time when the issue was tragically misunderstood.

What was also apparent was the different terminology: staff were called ‘Keepers’ in the 18th Century, and didn’t become nurses until the late 19th Century.

But thankfully, towards the latter part of the 20th Century, mental health became less stigmatised in wider society, and deinstitutionalised in terms of how care was provided. Here’s a rough timeline that notes some of the key dates in the professionalisation of Mental Health Nursing:

1774: Madhouses Act is the first legislation that recognises mental health as an issue

1808: County Asylums Act launches the first wave of so-called ‘lunatic asylums’

1845: Lunacy Act passed and commissioners put in place for the first time to oversee the treatment of mental health patients

1885: The so-called ‘Red Handbook’ is published, officially called ‘The Handbook for Attendants of the Insane’ – which offers mental health workers formalised instructions on care and treatment. In 1889 the first examinations for Mental Health Nurses were introduced by the Medico-Psychological Association (MPA), largely based on this handbook

1890: Another Lunacy Act passed in response to public concern that people were being wrongfully detained

1919: The Nurses Registration Act was passed, which introduced more examinations and assessments for Mental Health Nurses. Subsequently, they would become ‘Registered Mental Nurses’. However, many Mental Health Nurses continue to take MPA exams instead

1961: Enoch Powell, then Minister for Health, makes his famous ‘Water Tower’ speech which marks a shift towards ‘Care in the Community’ – a form of deinstitutionalisation which continues to this day.

1962: Hospital Plan introduces smaller, community-based hospitals. These are built throughout the 1970s as the larger asylums and mental hospitals of the past are gradually destroyed

1971: The Medico-Psychological Association becomes the Royal College of Psychiatrists

1999: National Service Framework for Mental Health sets modern service models which finally brings Mental Health Nursing in-line with other specialisms

What’s notable is that as these changes in legislation and education occurred, they roughly mirror changes happening in society. And these changes were dramatic. Mental health issues were once hidden and locked away, and now they’re increasingly out in the open. Patients were once ‘lunatics’, and are now patients like any other. Nurses were once keepers, and are now respected professionals. Mental Health Nursing is a profession transformed.

What does the future of Mental Nursing in the UK look like?

Recently, the Royal College of Nursing said in a report that Mental Health Nursing has experienced ‘significant upheaval’ in recent years – a view that’s widely shared.

Between 2014 and 2018, the number of registered Mental Health Nurses in the UK fell from 90,693 to 88,821. Meanwhile, funding and hospital beds for mental health patients has decreased, all while the size of the UK’s mental health problem has grown. The number of people being detained under the Mental Health Act, for example, has increased by a massive 34% since 2005-06. So something has to change.

One thing that has changed is society’s attitudes to towards mental health. A huge campaign launched by the charities Mind and Rethink shows that people are increasingly willing to live and work with sufferers of mental ill health.

Given that one of the key recruitment barriers has historically been a wider stigma concerning mental health, this is a good sign. Better attitudes towards mental health should mean better attitudes towards a career in Mental Health Nursing.

Following years of damaging cuts, a £1.3 billion increase in funding for Mental Health Nursing was promised in 2017. It was claimed this increased funding would increase the number of Mental Health Nurses by 21,000, by 2021.

Although the increased funding and focus was welcome, the announcement by then Health Secretary Jeremy Hunt was a little hollow. After all, as has been wisely pointed out by various experts in the field, Mental Health Nurses do not grow on trees. Recruitment is hugely challenging; training is long and complex.

In January 2019, applications for undergraduate nursing increased slightly year on year – but not by enough. So the government is now, belatedly, starting to focus on some of the more specific ways it can address this issue. A cash incentive for mature students to study Mental Health Nursing is now being planned. An online nursing programme that avoids the annual £9250 tuition fee has also been mooted.

But these plans will need to take shape quickly for the NHS to meet the nation’s growing mental health needs. Broadly, for qualified Mental Health Nurses the future could be bright, with a huge choice of roles and potentially a number of financial incentives. However, to ensure the burden on Mental Health Nurses isn’t overwhelming, recruitment and retention will have to drastically improve.

What does the future of Mental Health Nursing in the UK look like

What personal skills do you need to be a Mental Health Nurse?

It doesn’t take a genius to work out that Mental Health Nursing isn’t for everyone. All jobs have their challenges, but for RMNs the challenges really are unique. To make a success in this job, you’ll need a set of very specific personal skills.

First and foremost, you’ll need compassion. Yes, all nurses need to be compassionate – that’s a given. But as a Mental Health Nurse, your compassion will be tested in ways you could hardly imagine. If your compassion is conditional, it simply won’t hold out.

That’s because you might be dealing with a patient with psychosis who, completely unprompted, calls you every name under the sun. Or you might deal with a patient with dementia who, despite all your efforts and attention, regularly confuses you with someone else and coldly dismisses you. Your compassion and commitment to helping another human being has to be watertight.

This goes hand in hand with another skill you’ll need, too: resilience. The very nature of your job means that you often won’t find resolutions with your patients in the same way a General Nurse might.

In Mental Health Nursing, it isn’t necessarily about straightforwardly ‘fixing’ problems; you’ll be implementing plans that might last entire lifetimes. You’ll need patience, and you’ll need resilience.

And finally, it’s worth noting how important adaptability is too. Good Mental Health Nurses are like chameleons, adapting seamlessly to the unusual and unique care plans they have for their wide-ranging patients. Not only that, but you’ll probably have to quickly adapt to new wards and care settings all the time – settings that can be drastically different from one another.

Ultimately you’ll need a long list of personal skills to really suit this profession. But with compassion, resilience and adaptability, you’ll have a great core to work from.

What personal skills do you need to be a Mental Health Nurse

What do I need to know if I’m thinking of becoming a Mental Health Nurse?

To enter the world of Mental Health Nursing, you’ll need to be fully qualified.

For a Mental Health Nursing Degree programme you’ll need at least two to three GCSEs at C or above, normally in Maths, English and Science. Some universities require A-levels or other equivalent qualifications too.

Student fees are currently £9250 a year. Grants and bursaries may be available depending on your circumstances – but student loans are always an option. It’s worth noting that student loans aren’t repayable until you earn a minimum of £21,000 a year, and even then you’ll only pay a small chunk of your monthly earnings.

Your degree will consist of a mix of clinical placements and traditional classroom-based learning. And like other degrees, essays and examinations will form part of your studies.

Once you’ve passed your degree, you’ll need to register with the Nursing and Midwifery Council (NMC).

Read our full guide to becoming a nurse here.

In terms of what you’ll earn, you’ll begin work as a Band 5 Nurse, and therefore your starting salary will be £23,023 a year. Read our guide on Nursing pay and bands. This will increase every year – and as your career develops you’ll have the opportunity to progress into higher bandings. These bandings all bring with them higher starting salaries.

Once qualified, you’ll have a range of options in terms of how and where you work. You’ll likely work in the NHS, but you also have the option to work privately. You can work in a hospital ward, but you might also choose to work in the community.

Ultimately, as a Registered Mental Health Nurse, you’ll have a wide variety of options to choose from.

Below, we’ve picked out the best articles and videos from our own network of RMNs that will give you a more detailed insight into what you need to know before becoming a Mental Health Nurse.

What are the types of Nursing jobs available in Mental Health?

As a Mental Health Nurse you really are spoilt for choice when it comes to deciding precisely how and where you want to work.

Here’s a broad selection of some of the most common settings in which you might work:

Child and Adolescent Mental Health Services (CAMHS) – which typically offer inpatient acute service roles and community-based positions. Normally, you’ll be working in a CAMHS team, with social workers, doctors and counsellors, among others

Psychiatric Intensive Care Units (PICU) – this setting tends to offer a secure environment for helping patients with conditions that can’t be managed on an acute ward

Acute wards – these settings will usually segregate patients by age or gender, so could shape your career path greatly

Specialist units – these settings could mean you work with patients who have a very specific condition, like an eating disorder

GP surgery – in the community, many GP surgeries will employ RMNs to offer expert support to community patients

Prisons – this could mean working in an open prison, high secure unit, women’s prison or a young offenders institute

Care home or community care centre – unsurprisingly, many care homes employ Mental Health Nurses to provide specialist care on demand

This barely scratches the surface, with Mental Health Nurses appearing all over society. You may also work in a private setting, or even through a nursing agency. As an agency nurse, your role could quite literally change from one day to the next.

“I had always taken a particular interest in the pharmacological interventions used within Mental Health Services and how they had benefited the patients I worked with. In this article I will talk about my journey to prescribing, what the course was like, why I wanted to be able to prescribe and how it has contributed to my current role.” Laura Woods - read the full article here

For more information on the different roles on offer for Mental Health Nurses, and exactly what it’s like to perform those roles, here are some of our favourite articles from our own network of RMNs.

Browse Registered Mental Health Nurse Jobs

Nurses.co.uk provides the largest selection of jobs dedicated just to Nurses. Jobs are posted daily by NHS Trusts, private providers to the NHS, care homes, private hospitals.

We cover it all: Primary / community care, Secondary / hospital care, Specialist Nursing, care home.

The following links to jobs specifically for registered Mental Health Nurses.

Useful sites and further information for RMNs

For further reading, useful industry information and regulatory advice, check out some of the handy links below.

Nursing and Midwifery Council

The NMC is the regulator for Nursing and midwifery professionals. All Nurses must register through the NMC – and this is where Nurses can learn about revalidation too.

Visit www.nmc.org.uk
National Careers Service Guide

The government’s handy guide to Mental Health Nursing.

Visit nationalcareers.service.gov.uk
Unite the Union

Detailing the support Unite can offer Mental Health Nurses.

Visit unitetheunion.org
Mental Health Foundation:

One of the UK’s leading mental health charities.

Visit www.mentalhealth.org.uk
NHS bursaries

The government’s official advice on NHS bursaries.

Visit www.gov.uk/nhs-bursaries