Editorial
| Date | 01 May 2006 |
| Pages | 2-4 |
| DOI | https://doi.org/10.1108/17556228200600001 |
| Published date | 01 May 2006 |
| Author | Ian Baguley,Di Bailey,Peter Lindley,Peter Ryan |
| Subject Matter | Health & social care |
2
Editorial
It is arguable that issues surrounding workforce
development are now the most significant challenge to
the implementation of the National Service Framework
(NSF) and the NHS Plan (SCMH, 1997; 2000a; 2003;
WAT, 2000; 2001; Payne, 2000; Department of Health,
1999; Gournay & Birley,1998). The National Service
Framework (Department of Health, 1999) heralded new
standards and a new direction for mental health services,
one based upon a national network of new community
services including assertive outreach, crisis resolution
and early intervention underpinned by the needs of
service users and carers. The framework highlighted the
need for workforce development and training to
underpin these significant changes. The NHS Plan for
mental health services (Department of Health, 2000)
made 12 specific pledges including 1000 new graduate
primary care workers and women-only day services in
every authority. New money was promised to launch
these new initiatives and in many respects our mental
health services could reasonably begin to see themselves
as world leaders in the new community care. The Policy
Implementation Guidelines (PIG) (Department of
Health, 2001) provide detailed and specific information
on the staffing requirements and ratios for these new
services and the types of skills, approaches and
knowledge it was expected that workers would possess
for the future delivery of care.
The NSF, for example, highlighted key concerns
regarding the recruitment and retention of staff, and
creating a workforce representative of the community
served. There are difficulties with recruiting NHS mental
health staff such as psychiatrists (Appleby,2002), mental
health nurses (Ward, 2003), clinical psychologists and
therapists (Craik et al,1999; Lynam & Walker, 1999).
Some social services departments have similar problems
with the recruitment of adequate numbers of approved
social workers. There is subsequently a shortage of staff in
most of the major professional groups and the problems
are worse in inner city areas. These changes have
significant workforce implications. The aspirations of the
NSF cannot be delivered without a combination of
increased numbers of staff and the rapid enhancement of
skills and competencies (SCMH, 2000b).
Seven years on from the launch of the NSF, the
‘landscape’ of mental health services, certainly in
England, looks very different. For example, over 250
assertive outreach and crisis intervention teams have now
been implemented. However, the pace of change imposed
upon services to create ‘the new community care’ has
exacted a high price. Levels of occupational stress in
English mental services are higher than elsewhere in
Europe (see Hill et al,2006 in this edition). It is clear now
that the funding necessary to resource the ‘new
community care’ is simply not sufficiently available and
that there are funding crises in many mental health NHS
trusts (Gould, 2006). The modernisation agenda, leading
to an enforced and sometimes arbitraryapplication of
Agenda for Change and the Knowledge and Skills
Framework, has led to uncertainty and resentment about
inequitable treatment of individuals in certain sections of
the mental health workforce. The recent decision to revise
mental health legislation through amendments to the
1983 Mental Health Act rather than a substantive Bill,
nevertheless implies major changes to the ethico–legal
context in which we work. (see Kindermann, 2006 in this
edition for a view of the implications). As a result of all
these developments, mental health services are in the
midst of a process of fundamental change. Moreover, the
tragedy that befell David ‘Rocky’ Bennett (HSG 94, 27) has
seriously raised the issue of the mental health service
being institutionally racist (see Bennett, 2006 in this
edition, concerning the training implications).
Given these issues, the need for existing staff to work
in different ways is overwhelming. That is the challenge
for mental health: how do we disinvest in traditional
service models and roles and redirect monies into new
ones? It is clear from the implementation of new workers
like the graduate workers in primary care and psychology
associates that there are a large number of people who
would like to work in mental health but do not want to
follow a more traditional route. Similar challenges exist
for the universities and colleges involved in education and
Ian Baguley, Di Bailey, Peter Lindley and Peter Ryan
Editors, The Journal of Mental Health Workforce Development
The Journal of Mental Health Workforce Development Volume 1 Issue 1 May 2006 © Pavilion
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