Mental health nurse

Mental health nurses support people with mental health conditions through their recovery process, helping them to improve their quality of life and live independently

You'll support not only your patients but their support networks, such as relatives or close friends, as well.

To aid patient recovery you may advise on suitable therapies, activities or groups, administer medication and identify and respond to any potential risks. You'll also plan and provide care, encourage patients to engage with therapeutic and clinical interventions and empower them to expand their knowledge about their mental health condition to gain better control over it.

Your patients may experience mental health problems including depression, anxiety disorders, schizophrenia or other forms of psychosis, personality disorders, post-traumatic stress disorder (PTSD) or addiction. Additionally, you may choose to specialise in working with certain groups, such as patients with physical or learning disabilities, patients with autism, the elderly, women, patients with eating disorders, children within the child and adolescent mental health services (CAMHS), and forensic patients.

Types of mental health settings

You may work with patients in a variety of environments, including:

• hospitals
• residential settings
• prisons
• in the community.

Work is often carried out in a multidisciplinary team (MDT), composed of various healthcare professionals. You'll liaise with other mental health professionals, including nurses, psychiatrists, psychologists, psychotherapists, occupational therapists, counsellors, GPs, social workers, addiction specialists, and healthcare assistants (HCAs).

Responsibilities

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

• utilise a person-centred approach to discuss the best way to deliver patient care and support them through their recovery process
• build professional and therapeutic relationships with patients to encourage trust, while listening to and interpreting their needs and concerns
• carry out frequent patient observations and make a record of these for the use of other healthcare and legal professionals
• support senior mental health nurses with their duties
• ensure the correct administration of medication, including injections, and monitor the results of treatment
• engage in regular supervision to support your emotional wellbeing and discuss difficult patient cases
• respond to distressed patients in a non-threatening manner and encourage them to use healthy coping strategies to manage their discomfort
• help patients manage their emotions through verbal de-escalation techniques
• use physical intervention techniques to moderate patient behaviour during periods of intense distress or high risk
• conduct clinical reports and risk assessments for each patient in your care and ensure these are updated regularly
• facilitate group and/or one-to-one therapy sessions, such as cognitive behaviour therapy or dialectical behaviour therapy, both individually and with other healthcare professionals
• organise events aimed at developing patients' social skills and help to reduce their feelings of isolation
• develop and implement patient care plans
• attend MDT meetings, and liaise with patients’ family members and external care teams to understand and discuss patient treatment and recovery
• conduct room checks, in secure hospitals and prisons, to prevent contraband items from negatively impacting patient recovery or increasing risk of harm
• visit patients in their home, in community mental health roles, to monitor progress and carry out risk assessments with regard to their safety and welfare
• maintain patient confidentiality whilst adhering to safeguarding principles and ensuring that the legal requirements appropriate to a particular setting or group of patients are observed
• support patients with physical, emotional and personal care needs
• encourage patient engagement with their treatment plans, including taking prescribed medications and engaging with therapeutic interventions
• identify and respond to patient risk behaviours to limit harm to themselves or others.

In more senior mental health nurse roles, you could also be expected to:

• lead shifts by being the main point of contact for other nurses and healthcare professionals
• mentor newly qualified mental health nurses to aid their professional development.

Salary

• Newly qualified mental health nurses typically start on salaries of £28,407 rising to £34,581. This is equivalent to Band 5 of the NHS Agenda for Change pay rates.
• As you progress, you'll work your way up through the bands. The most experienced mental health nurses earn between £35,000 and £45,000 or work at Band 6 or 7 in the NHS.
• Senior mental health nurses can earn higher salaries of £42,000 to £59,000. If you work for the NHS, you'll be paid at Band 7 or 8a rates.

Mental health nurses working in London are entitled to an extra allowance of between 5 and 20%. The amount will depend on your proximity to central London. You may also receive a slightly higher rate of pay if you choose to work in the private healthcare sector.

Additional employee benefits will depend on your location and sector of work. Many employers will offer free or subsidised DBS checks and uniforms, a good pension and access to an NHS blue light card, or other discounts. Depending on available facilities, benefits could also include free meals and parking, and reduced rates for the gym or accommodation.

Income figures are intended as a guide only.

Working hours

You'll typically work between 37.5 to 40 hours per week. In residential and hospital settings where patients require 24-hour care, it's common for mental health nurses to work 12 or 12.5-hour shifts.

Although you'll often be expected to work evenings, weekends and bank holidays, some employers may offer alternative working arrangements, such as different shift patterns. Due to the nature of the role, you are unlikely to have the option to work from home but can still achieve flexible working through part-time or bank work contracts.

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

What to expect

• The role can be quite physically demanding and have an element of personal danger. You may have to physically restrain patients or move around to respond to risks.
• Since the role can be stressful and upsetting on occasions, it's important that you maintain a healthy work/life balance and positive state of mental wellbeing. Many employers will support this by providing regular supervision, as well as access to counselling, mindfulness and other wellbeing support.
• You might be required to have a driving licence and access to your own vehicle, particularly for mental health nurses working in the community, as you may need to travel across a broad geographical area throughout the working day.
• Depending on your location, you may be expected to wear a uniform. Some employers will provide this free of charge or at a subsidised rate.
• Because your patients are classified as vulnerable individuals, you'll need to pass an enhanced DBS check before you can be accepted into your position. Some employers will provide this free of charge. You'll need to declare any criminal convictions, charges or cautions, and be open to discuss these if they are mentioned in any interviews.

Qualifications

You need to be registered with the Nursing & Midwifery Council (NMC) to work as a registered mental health nurse (RMN) in the UK. The most common way is to complete a pre-registration nursing degree delivered by an NMC-approved education institution (AEI).

Nursing degrees typically last three years full time. Part of your degree will comprise clinical practice, which will give you experience of working with patients and their families.

A small number of universities offer part-time nursing degrees, lasting six years. Some institutions also offer four-year dual field degrees, allowing you to study in two of the above areas. 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. For a list of recognised programmes, see NMC Approved Programmes.

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.

Registered nurse degree apprenticeships (RNDAs) are also offered by some employers and the amount of them is expected to grow. These typically take four years to complete and are a more flexible way to study. You'll need to secure a RNDA position with an employer who will cover the cost of the RNDA and release you for part-time study at university. You'll complete practical training in a range of settings from hospitals and mental health facilities to patients' homes.

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

Skills

You'll need to have:

• excellent observational skills to assess patients, administer medication and look out for triggers of risk behaviours
• good organisational and time-management skills to manage your caseload efficiently
• effective verbal and non-verbal communication and the ability to support individuals with varying levels of understanding
• good psychological, medical and legal knowledge
• strength, stamina and physical fitness particularly if working in a hospital or secure residential unit
• the flexibility to adapt to different shift types and the dynamic nature of the role
• the ability to follow care plans to ensure that patients are provided with high-quality, person-centred care
• good written communication for writing reports and updating patient records
• excellent interpersonal skills for developing professional relationships with colleagues, patients and their families
• the ability to stay calm and think quickly in challenging circumstances
• good teamwork skills
• resilience, self-awareness and a positive attitude
• active listening skills and a compassionate nature
• good decision-making skills and knowledge of mental health first aid for responding appropriately to patients during mental health crises
• an empathetic and non-judgemental approach 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 dedication. You could gain this through work or voluntary experience in a role that involves caring for others. For example, this could be carried out in a community setting, hospital or mental health charity.

In addition to the placements that you'll complete during your nursing degree, you could work as an HCA to gain relevant work experience. Work shadowing a nurse or talking to some about their role will help to manage your expectations about the realities of being a mental health nurse.

It can also be helpful to gain experience working with particular groups of clients if you are considering specialising. This can include experience working with children, or with older clients in a residential home.

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

As a mental health nurse, you can work in a variety of environments across the public and private healthcare sector. Most mental health nurses work for the NHS, but you could also choose to work privately for one of their providers or other large private healthcare companies. There are options to work in hospitals, residential settings, or in the community.

This could include working in:

• outpatients departments
• psychiatric wards
• rehabilitation services
• specialist or psychiatric intensive care units
• GP's surgery
• community health centre
• residential centre
• the patient's own home
• prisons
• 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 patients with a specific mental health condition. Occasionally, there are also opportunities for self-employment.

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

Jobs can also be found on specialist recruitment agencies, such as Pulse, and the websites of medical charities and private healthcare companies, such as Cygnet, Elysium, St Andrew's, and the Priory Group.

Professional development

As a newly registered mental health nurse, you'll usually have the opportunity to take part in a preceptorship programme. This transition phase is designed to help you further develop your knowledge and practice with the support of more experienced healthcare professionals. 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 a minimum of 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.

Throughout your career as a mental health nurse, there will be further opportunities to invest in your professional development, such as becoming a mentor to support practicing nurses. If you choose to work with a specialist group of patients, then you may also be offered training where you can learn how to better support them and manage their risks. Most mental health nurses will also receive physical intervention training, such as MAPA or PMVA. Alternatively, competence in these interventions may be a prerequisite to securing a mental health nurse role.

Career prospects

There are various routes you can take to progress your career as a mental health nurse. You could become a specialist nurse or advance into positions of seniority as a nurse practitioner, nurse manager, nurse consultant, ward manager or hospital manager.

For these positions, you're likely to need further qualifications, possibly at Masters level, as well as relevant experience. In some cases, the more senior posts have fewer hands-on nursing responsibilities, and you may be more involved in clinical research, mentoring and promoting best practice.

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.

For nursing leadership roles, the NHS Leadership Academy provides programmes to support nurses at all career levels.

The availability of nursing positions in universities means that you could also progress into an academic role. These include opportunities to work as a lecturer or researcher, where you can teach and mentor nursing students, or contribute towards the advancement of specialist clinical knowledge and best practice within the healthcare profession.

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.