“Why is there a shortage of internships for mental health nursing students? »

It was a happy day when we were to celebrate the end of the year party with the third year mental health nursing students.

As a registered mental health nurse, nurse educator and nurse researcher, it was with mixed feelings that I listened to my colleagues and praised students, and talked about how to decide on their career choices. , including clinical, research and academic.

“Unfortunately, this decision had created, and still creates, a lot of challenges”

My colleague, Queen Ng’ambi-Nyirenda, a nurse lecturer in learning disabilities, then took the floor. As she spoke, I took off my mental health nurse hat as my mind dipped into a branch of nursing in which I have limited experience, learning disabled nursing.

Indeed, over the years and in recent times the Royal College of Nursing, the All Party Parliamentary Disability Group, Mencap and others have written extensively about the alarming rate of staff shortages for learning disabilities and for learning disabled nursing students and mental health nursing. students.

Granted, there are established shortages of nurses in general and of nurses with learning difficulties, but there is a more difficult problem, that of student nursing placements.

Yes, placement opportunities for nursing students remain a huge challenge for universities, NHS trusts and nursing students, especially in the era of Covid-19, closures and infection rates brought up in hospitals.

As a mental health nurse, I will focus specifically on the lack of adequate mental health nursing placements.

Therefore, the question remains, what is the reason for the shortage of nursing internships for mental health nursing students?

Hmmm, I was thinking…that’s a question I would have answered with “your guess is as good as mine”, but in this case, mine isn’t a guess.

You see, as a nurse researcher, I conducted an ethnographic study that explored the place, people, and involvement of an informal community mental health service.

During an initial scoping review of mental health cafes and a literature review of four informal community mental health services, I noted that in 2001 the World Health Organization advocated that countries are reducing the number of acute mental health services and moving mental health services to the community.

“Research has pointed to the insufficient number of statutory community mental health services”

The WHO has highlighted the need for a paradigm shift from acute inpatient mental health care to community-based mental health care.

This change was based on the premise that community-based mental health care was: less stigmatizing, can speed up early intervention, was more cost-effective compared to the hospitalization model, and respected the human rights of people with mental health issues.

The WHO mandate, while a positive change for mental health service delivery, did not consider how the closure or limited availability of acute inpatient mental health services might affect the availability of nursing internships.

Unfortunately, this decision has created, and still creates, many challenges for universities, NHS trusts and mental health nursing students who need to learn clinical skills to be able to practice safely.

Most importantly, the shortage or unavailability of placement opportunities was worse during the lockdown when qualified nurses and students worked and continued to work in the few acute mental health services and community mental health facilities; where they were exposed to Covid-19, leading to a high incidence of illness and death.

Do not mistake yourself. I am fully aware that acute psychiatric inpatient hospitals are not the only setting where mental health nursing students can learn the required skills. Indeed, there are community mental health services.

But. Yes, there is a big but. Research data pointed to the unavailability and insufficient number of statutory community mental health services.

So what can we do about the dearth of placement opportunities for mental health nursing students?

There are other community mental health resources that I call “informal” community mental health services, such as drop-in centers and lodge, and mental health cafes, which I want to focus on.

Certainly a quick Google and Google Scholar search yields different descriptive names, such as informal mental health care.

“There is an urgent call to raise awareness about placements in informal community mental health services”

There are definitions of what mental health cafes are, but using a collection of terms from published and unpublished studies on relevant databases and websites, and the results of my study, I have developed a full definition of mental health cafes.

It is: “A mental health café is an informal community mental health service that provides a space where anyone, with or without mental health issues, can go to eat and drink, socialize and access free creative activities .”

Therefore, although acute inpatient mental health hospitals and formal community mental health services are available, there is an urgent need for universities to raise awareness of alternative placement opportunities within informal community mental health services.

Credit should be given to universities that have already committed to placing students in informal community mental health services.

With increased student awareness of what informal community mental health services are and opportunities to learn additional skills for best practice, I hope more mental health nursing students can begin to appreciate the knowledge base that community services can provide.

Dr Josephine NwaAmaka Bardi is Senior Lecturer and Head of Student Engagement, School of Nursing and Midwifery, London South Bank University

About Mark A. Tomlin

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