Scottish Mental Health Nursing Review

9. Theme 4: Nurturing the Mental Health Nursing Workforce

9.1 What we heard

Mental health nurses have told us that the profession is a rewarding occupation, with the most fulfilling aspect being the opportunity to support people on their recovery journey. However, it is important to note that many participants highlighted the impact of service pressures and vacancies had on their own wellbeing, with some reporting feeling overwhelmed, burnt out, powerless, undervalued, and exhausted.

Some participants felt that they were not valued by management, and that other health professionals did not respect or value the role of a mental health nurse. A few participants mentioned that they did not feel heard and felt ignored and isolated by local managers. The need to listen and involve staff in service evaluation and design/re-design was also echoed throughout our engagement.

To help ensure wellbeing and motivation at work, and to minimise workplace stress, the ‘Courage of Compassion’ report (Kings Fund, 2020) identified three core needs for individuals:

• Autonomy – the need to have control over their work lives, and to be able to act consistently with their values
• Belonging – the need to be connected to, cared for, and caring of others around them at work, and to feel valued, respected and supported
• Contribution– the need to experience effectiveness in what they do and deliver valued outcomes.

All three core needs must be met for people to flourish and thrive at work. Mental health nurses across all sectors hold both an individual and collective responsibility to be mindful of these needs, and to contribute towards achieving them.

The need to offer greater support to staff, in general working terms but also support for vicarious trauma and those dealing with challenging situations, was also highlighted through the National Conversations. This was echoed in research findings from various countries, which described the importance of supportive work environments, opportunities for professional development, and the optimisation of time spent on patient care in enhancing job satisfaction and retaining nurses in mental health settings.

We know that mental health nurses across all sectors, along with wider colleagues in health, social care and social work professions face significant pressure. It is essential to ensure that support is sustainable and responsive to current and emerging needs, at national and local levels.

The findings from the Review highlighted the importance of nurturing and empowering the mental health nursing workforce, protecting their wellbeing and psychological safety. There is compelling evidence which demonstrates that positive wellbeing enhances staff retention, which in turn raises standards of patient safety and quality of care.

As highlighted in the Nursing and Midwifery Taskforce Report and Workforce Action Plan, staff wellbeing is paramount, including ensuring that staff can take their entitled breaks and leave, along with time to access wellbeing resources, which is essential in preventing burnout. Mental health nursing staff can also access a range of services to care for their physical and mental health. This includes employee assistance programmes, trauma counselling services and pastoral support, to ensure a safe working environment.

Students provide feedback on their practice learning experience using a form which is available via the Quality Management of Practice Learning Experience system (QMPLE). This feedback is utilised as a quality enhancement mechanism and enables practice learning environments to take account of student's experiences whilst on placement and, thereafter, to implement improvements based on this.

The Student Mental Health Action Plan , published in September 2024, sets out a mainstreamed approach to student mental health. The Government will work in partnership with NHS Boards, CoSLA, Public Health Scotland and community-based providers to join up support that is already available. The Action Plan recognises the importance of each college and university having a Student Mental Health

Agreement in place which brings together the institutions and students’ associations to develop and promote their mental health work with students.

All of these resources play a vital role in helping the mental health nursing workforce manage their own wellbeing, challenges at work and enhancing the quality of care that they can provide.

The Scottish Government is committed to collaborating with leaders and staff in health, social care, and social work to identify and address areas of stress, and to explore additional actions to support staff.

Through implementation of the Mental Health Nursing Principles for Care and Practice Framework (Action 1), the mental health nursing profession will champion a psychologically safe, trauma-informed and trauma responsive working culture to ensure a safe and supportive environment is in place which empowers all mental health nurses.

Building on this and further work actions highlighted in the Nursing and Midwifery Taskforce report and Workforce Action Plan, our Advisory Groups identified the following specific priorities for our mental health nursing community:

19. ACTION: Promoting, embedding, and monitoring the use of the recently published Clinical Supervision Frameworks for mental health nurses across all sectors.

20. ACTION: Working with the Council of Deans and NES, we will encourage Higher Education Institutions and mentors to embed the use of the Clinical Supervision Framework for mental health nursing students.

21. ACTION: An employer commitment for mental health nurses to ensure the use of protected contractual time for supervision, linked to Nursing and Midwifery Taskforce Action 17. To monitor the implementation of this commitment, we expect all mental health nurses across sectors to report incidents where their protected contractual time for supervision is not adhered to and the reasoning for this through locally agreed governance structures.

22. ACTION: Drawing upon nationally available support, such as Flying Start NHS®, the Mental Health Nurse Leads Group will seek to build on existing best practices to develop a test of change framework that supports newly qualified mental health nurses as they transition into registered practice and also mental health nurses who change roles, that can be replicated at a national and cross sector approach.