Dear Critical Mental Health Nurse,
Greetings from the Midlands, United Kingdom, to wherever you are!
When ten of us mental health nurses began this journey nearly ten years ago, first with discussions and later the formation of a critical mental health nurses network, a couple of conferences and a website, we did not know what would happen, where it would go, who would come on board and what discussions would take place.
In fact, it seems that this first ten years have really led in three directions. The first was that contributors to the network decided we needed to have our own book. Published by PCCS in 2018 (how proud we are to be included in that catalogue!), Critical Mental Health Nursing: Stories from the Inside, eds Bull, Gadsby and Williams has been taken up onto the reading lists of several university mental health nursing courses. The ‘apology’ chapter, written by the three editors, caused a few heated exchanges with some practice and academic colleagues, one of which was an email in which the author (a senior lecturer) said they were so angry they could not read beyond the first five lines. Well. We wouldn’t have wanted it to be boring…
The second direction has undoubtedly been towards thinking about nurse education. At one point an idea surfaced to publish critical teaching aids and lesson plans for mental health nurses on this website and that could still happen. A duo of lovely nurse educators from New Zealand met with some of us to tell us about the critical work they have been involved with for many years. The critical content of my own mental health nursing course in Birmingham has grown very much in line with student demand – not demand for controversy per se but a demand from students to understand their own conflicted thoughts and emotions about the role into which they are being led. I still consider myself a new-comer to nurse education and I am so grateful for all the students are teaching me. In September this year I will start to teach a 5 week course that is as full of critical thinking as I could wish, for third year undergraduate nurses. There will be a lot of challenges and a lot of hard work, but I will sleep more easily knowing that I am really getting to push my students to be the thinkers that our service-users deserve… and to be compassionate people with strong hopes and values, too. I wrote a chapter about my early experiences of teaching critical material to mental health nurses in a book also published by PCCS, Inside Out, Outside in: Transforming Mental health practices. My new module has taken me 18 months to write and I will try to turn it into a book after it has run a few times (because the students will teach me all of the things that are currently wrong with it!). Once again, I am so grateful to other critical mental health nursing academics for their support and encouragement, including the teams that have put my chapter on their reading lists.
The third direction was unplanned. I was asked to give a paper at the Mental Health Nurses Academics UK/RCN annual mental health conference in 2018. Either by a mix up or something else, this ended up being the final paper of the conference, delivered to all of the delegates. I spent an intense month writing that paper and was somewhat surprised to find it was leading to a call for a new provision of conscientious objection for mental health nurses, in order for them to be able to object from being part of enforced pharmaceutical interventions. I had never really thought quite that way before. There was a lot of very positive feedback in the room and I was immediately and rather breathlessly interviewed by The Mental Elf about it.
Some will remember that we then hosted three evenings on Twitter to discuss the idea. Twitter, I have to say, is something I have had energy for at times and not at others. Nevertheless, the nurses and others that took part were so thoughtful and dedicated… and I went away promising to try to write it up. I did, but it became a longer and longer document, much more than a standard book chapter. One cannot just write 9000 words and then look for a publisher; that is not how it works! I got a bit stuck and it sat on my laptop for two years. I knew it was important, I knew it was a new angle on some very old problems, I knew it could lead to promising and productive kinds of trouble, but I couldn’t work out how to finish it! Eventually, Prof Mick Mckeown at UCLan came to the rescue, like a hugely-experienced, deeply-respected and highly-published Scouser in shining armour. He helped me get it finished and he also found the perfect place to have it published.
It has been published this week. Sadly, owing to the fact that academics are nothing like as clever as we might hope to be, we have allowed ourselves to get into a situation in which we volunteer labour and then cannot afford to pay for the results. Wiley publisher’s ‘Nurse Philosophy’ is a great home for this paper but even I cannot access it for free; I had to get a contact at a richer university to send me a PDF! Obviously, it is not legal for me to share that PDF here, although I can share the link.
Instead, I will try to create an accessible summary as soon as I can and post it here. Or I might skip that and work with Mick to move straight to trying to write some kind of open letter to the NMC, which will certainly be posted here and circulated for signatures. If this issue feels important to you and you would like to help us think about what the next steps should be, then do get in touch – this is an open network of nurses, not a member’s only club (people often email me and ask how they can join…. I tell them, you just did).
It is, I hope, a document that demonstrates some hard thinking, reflects the helpful inputs from those involved in the Twitter discussion and tries to anticipate concerns and questions that will arise. It is not supposed to be the final word, but rather the opening of a conversation. It will be a difficult conversation, but as I look around I believe it is a conversation we mental health nurses are ready for.
Best wishes to you, fellow mental health nurses, in all of your endeavours to be with people in distress in productive and restorative ways,