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‘There is a stigma in training’: the battle to find mental health workers

This article was taken from: https://www.theguardian.com/society/2019/may/15/battle-to-find-mental-health-workers

By Debbie Andolo

Recruitment figures for psychiatrists and nurses are poor, although there are signs that things may be starting to shift

At first glance the recruitment and retention statistics for the mental health workforce look grim. Vacancies for mental health nursing – the largest staff group in the sector – account for more than 20% of all unfilled nursing posts in England, while around 9% of UK consultant psychiatric posts remain unfilled. In September 2018, MPs were told that 2,000 mental health staff in England alone were quitting every month. There is little doubt then that the government is way off meeting its target to create another 21,000 new posts in mental health by 2021.

But look a little closer and there are indications that things are starting to shift and that the skilled workforce, so crucial to the delivery of mental health care – which is at the heart of the government’s NHS long term plan – is showing signs of growth.

A 2017 recruitment campaign by the Royal College of Psychiatrists (RCPsych) helped boost the number of junior doctors deciding to train in psychiatry by 30% last year. Its success, according to Dr Kate Lovett, consultant psychiatrist and RCPsych dean, is down to a new focus. “We put the voice of the patient, rather than the doctor, at the centre of the campaign,” she says. “It was very powerful; we used real doctors and had actors speaking the words of patients. We wanted to change the narrative, to show psychiatric medicine as it really is.”

NHS Employers – the voice of NHS trusts in England and Wales – thinks the additional pay premium it negotiated in the 2016 junior doctors contract, worth £20,604 over six years, is also having an impact.

Lovett believes a variety of factors have been deterring medical students and junior doctors from joining psychiatry. “I think there is a stigma about mental health in training,” she says. “There is that negative attitude from senior role models that mental health is a poor relation. You get derogatory comments like: ‘you could do anything – why are you doing psychiatry?’ Those kind of comments put medical students off. But why is it that people experiencing mental illness don’t deserve the best and brightest doctors?” Lovett says she never regrets her career choice. “I get the biggest buzz when I see somebody who has been really ill get better.”

Medical schools may also be making the recruitment problems in the sector worse by selecting the wrong kind of students – ignoring those school leavers who might naturally be attracted to a psychiatry career. Only three UK medical schools, according to Lovett, accept psychology A-level as entry to medicine. It is an issue being addressed by Health Education England (HEE). Last year, HEE commissioned the national workforce skills development unit at the Tavistock and Portman NHS foundation trust in London to look at the potential NHS career paths for psychology graduates. Its interim report is due this summer.

With nurses making up the majority of the mental health workforce, and applications to UK undergraduate nursing only slighting increasing this January, the government is keen to think of new ways of attracting students. Its NHS long-term plan proposes a cash incentive to attract mature studentsto study mental health nursing, and also promises an online nursing programme without the £9,250 annual tuition fee attached to the face-to-face programmes in England. The cash premium – mooted to be around £5,000 – is dependent on the NHS winning the money in the government spending review later this year.

“The big issue we are faced with is nursing,” says NHS Employers’ chief executive Danny Mortimer. It is imperative that the treasury understands the value of financial incentives for the nursing workforce, says Mortimer, but also that any incentives should not only apply to mature students: “They should be for all mental health nurses, whether you are 18 or 38 – the need is so great.”