Mental health nurse

As a mental health nurse, you'll help people with mental health conditions by supporting their recovery or helping them to live independently while improving their quality of life

You may advise on suitable therapies, activities or groups, help with medication and identify any potential risks. You'll plan and provide care and will encourage the patient to get more involved with their condition to gain control over it.

You can specialise in working with certain groups, such as children or older people, or in a specific area such as eating disorders, psychosis, personality disorders, drugs and alcohol, depression and anxiety, or obsessive compulsive disorder.

Work is often carried out in multidisciplinary teams, liaising with psychiatrists, psychologists, occupational therapists, GPs, social workers and other health professionals.

You may work with patients in a variety of settings including:

• their own homes
• community healthcare centres
• hospital psychiatric wards or specialist units
• hospital outpatients departments
• specialist units
• secure residential units.

Responsibilities

As a mental health nurse, you'll need to:

• assess and talk to patients about their condition and discuss the best way to plan and deliver their care
• build relationships with patients to encourage trust, while listening to and interpreting their needs and concerns
• ensure the correct administration of medication, including injections, and monitor the results of treatment
• respond to distressed patients in a non-threatening manner and attempt to understand the source of their discomfort
• help patients manage their emotions through de-escalation techniques
• prepare and participate in group and/or one-to-one therapy sessions, both individually and with other health professionals
• provide evidence-based individual therapy, such as cognitive behaviour therapy for depression and anxiety
• organise social events aimed at developing patients' social skills and help to reduce their feelings of isolation
• prepare and maintain patient records and produce care plans and risk assessments
• make sure that the legal requirements appropriate to a particular setting or group of patients are observed
• work with patients' families and carers, to help to educate them and the patient about their mental health problems.

If you work in the community, you may also need to:

• visit patients in their home to monitor progress and carry out risk assessments with regard to their safety and welfare
• liaise with patients, relatives and fellow professionals in the community treatment team and attend regular meetings to review and monitor patients' care plans
• identify whether/when patients are at risk of harming themselves or others.

Salary

• Fully qualified mental health nurses start on salaries of £28,407 rising to £34,581 on Band 5 of the NHS Agenda for Change pay rates.
• As you progress, you'll work up through the bands. Most experienced nurses work at Band 6 or 7 with salaries ranging from £35,392 to £50,056.
• One of the highest paid positions in nursing is as a nurse consultant, where salaries start on Band 8a ranging from £50,952 to £57,349.

Extra allowances of 5% to 20% are payable in the London area, depending on your proximity to inner London.

Income data from Health Careers. Figures are intended as a guide only.

Working hours

You'll typically work 37.5 hours per week. This may include evenings, weekends and bank holidays. In residential and hospital settings, 24-hour care is usually required, meaning shift work is likely.

If you work in the community you're more likely to have regular hours, although you may need to carry out on-call duties for emergency situations.

What to expect

• A large proportion of mental health nurses work in the community, although some provide in-house care.
• Vacancies occur throughout the UK, particularly in cities and towns. Skills shortages may occur in some specialisms so it's good to research this when thinking of which area of mental health is for you. There is a current growth in the need for child and adolescent mental health services.
• It's important to maintain a positive work/life balance. This can be difficult due to the level of personal commitment and working patterns required.
• The role can be stressful and upsetting on occasions and there can be an element of personal danger and the potential for violent behaviour, although you'll be taught how to identify and diffuse building tension. However, it can also be an extremely rewarding role.
• Local travel during the working day is common for community psychiatric nurses (CPNs).

Qualifications

You need to be registered with the Nursing & Midwifery Council (NMC) to work as a mental health nurse in the UK. To be eligible to register you must complete a pre-registration nursing degree or registered nurse degree apprenticeship delivered by an NMC-approved education institution (AEI).

Nursing degrees can be taken in four disciplines:

• adult
• children
• learning disability
• mental health.

A small number of institutions offer dual field degrees, allowing you to study in two of the above areas.

Degree courses last three years full time, four for dual field (or degree courses in Scotland). Part of the programme is based in clinical practice, giving you experience of working with patients and families.

You may be able to get accreditation of prior experiential learning (APEL) if you have practice-based learning or a degree in another health-related subject, such as life and medical science, social work or psychology. Having APEL may shorten your course to two years, but this is at the discretion of individual institutions so it's always best to check.

The NMC states that good health is necessary to practise as a nurse, but this doesn't mean that you'll be exempt if you have a disability or health condition. You'll also need to declare any criminal convictions, charges or cautions. A criminal record may not be a bar to training, but would be the subject of full and open discussion at interview.

For a list of recognised programmes, see NMC Approved Programmes.

A non-repayable training grant of at least £5,000 a year is available to nursing students while at university. For more information, see Health Careers.

Registered nurse degree apprenticeships (RNDAs) are offered by some employers and the amount of them is expected to grow. These are a more flexible way to study as you’re not at university full time. Instead, you'll need to secure a RNDA position with an employer and they will release you for part-time study at university. You'll complete training in a range of settings from hospitals and mental health facilities to patients' homes.

RNDAs typically take four years to complete and the cost is covered by your employer. You may be able to do it in a shorter length of time if you have APEL.

If you're working in a healthcare support role, you may be able to apply for a nursing associate apprenticeship, which can be seen as a way into nursing as it's possible to progress on to a shortened nursing degree or RNDA.

Skills

You'll need to show:

• excellent observational skills to assess patients and look out for signs of tension or anxiety
• strength, stamina and physical fitness particularly if working in a hospital or secure residential unit
• excellent communication skills for dealing with patients and their families
• the ability to stay calm and think quickly in challenging circumstances
• emotional resilience and a non-judgemental approach
• skills in decision making and time and stress management
• empathy with patients and the situation they're in and ability to advise them on how to deal with their condition
• the ability to help others overcome social stigma related to mental health.

Work experience

Having relevant work experience is useful when applying for courses or jobs as it shows your interest in and dedication to the profession. This can include community work or voluntary work in a hospital or with a mental health charity. Any experience that involves caring for others, such as in a care home, is useful.

You could also try to shadow a nurse or talk to some about what the job is really like so you have a realistic idea of what is involved.

For free mentoring resources and experiences designed to support aspiring healthcare and legal professionals - including virtual work experience that is accepted by medical schools, see Medic Mentor.

Find out more about the different kinds of work experience and internships that are available.

Employers

The NHS employs the majority of mental health nurses. While some work is carried out in mental health and secure hospitals, most roles are based in the community.

This could include working at a GP's surgery, community health centre or residential centre, as well as in a patient's own home. You could also work in units within prisons or for telephone helplines. If you work in a hospital, you could be based in the outpatients department, psychiatric wards or specialist or psychiatric intensive care units.

Outside the NHS, leading employers include:

• large private healthcare companies
• mental health charities
• the armed forces.

Some projects are jointly run by the NHS in partnership with social services, local authority departments or other agencies. Many posts offer the chance to work in a more specialist role with a particular group of clients or involving those with a specific mental health condition.

Look for job vacancies at:

• Health Jobs UK
• HSC Jobs - for health and social care jobs in Northern Ireland.
• NHS Jobs - also includes adverts for registered nurse degree apprenticeships (RNDAs).
• NHS Scotland Recruitment
• RCN Bulletin Jobs

Also check the websites of medical charities and private healthcare companies.

Specialist recruitment agencies, such as Pulse, often handle vacancies. For contact details of various consultancies try the Nursing Agencies List.

Professional development

As a newly registered mental health nurse, you will usually have the opportunity to take part in a period of preceptorship. This transition phase is designed to help you further develop your practice and gain in confidence. It covers fundamental competencies in patient care as well as broad skills in leadership, management, teaching and communication.

Your registration with the NMC must be renewed every three years. To do this you need to show you have met revalidation requirements within that time, including completing 450 practice hours, which can be made up of providing care to patients, managing teams, teaching others or running a care service.

You'll also need to do 35 hours of continuing professional development (CPD), including 20 hours of participatory learning, where you'll interact with at least one other professional. It can include attending conferences, training courses and events.

In addition, you'll also need to submit five pieces of practice-related feedback, five written reflective accounts, a reflective discussion and a health and character declaration, as well as having a professional indemnity arrangement. Find out more at NMC Revalidation.

In Scotland, all newly qualified nurses are entitled to participate in Flying Start NHS. This is a personal development programme aimed at building your confidence and supporting your learning in your first year of practice.

Post-registration specialist practitioner courses are available and usually last for one academic year, although some can be completed in a shorter time if credit is given for prior learning and experience. Courses cover topics such as clinical practice development and leadership.

Career prospects

There are various routes you can take to progress your career as a mental health nurse. You could become a specialist nurse, either working with a specific client group such as offenders or children and young people or with a specific area such as alcohol or substance misuse, forensic psychology or psychotherapeutic interventions.

There are some opportunities to progress further into posts such as advanced nurse practitioner, nurse manager or nurse consultant, which may also open up opportunities to work in a more specialist role. For these positions, you're likely to need further qualifications, possibly at Masters level, plus relevant experience. In some cases, the more senior posts have less hands-on nursing responsibilities and you may be more involved in research and promoting best practice.

Roles as a nurse leader are also available which could see you managing a ward or leading a team of nurses. The NHS Leadership Academy provides a number of programmes to help nurses into leadership roles at all levels of your career.

There are also opportunities to move into educational roles, such as:

• lecturer - teaching students at universities
• lecturer practitioner - continuing to deliver care to patients
• mentor - supporting and helping to train student nurses
• preceptor - providing support to newly qualified nurses
• researcher - playing a key role in ensuring that the nursing profession is enhanced and informed by specialist knowledge.

It's possible to join a unit or trust management team in an advisory or executive capacity, making decisions that directly affect patient or client welfare, including financial and staffing matters.

There are increasing opportunities in the private and independent healthcare sectors, or you may choose to move into roles in social services, the prison service, voluntary organisations or residential nursing homes. There are also opportunities overseas for qualified and experienced UK nurses in a range of countries.

For more information on career prospects, see the Royal College of Nursing Careers resource for registered nurses.