Mental health nursing policy - an exploratory qualitative study of managers' opinions

During the 1990s, much of the legislation and policy that pertains to menta l health services has sought to direct them towards a virtually exclusive c oncern with the seriously mentally ill, typified by the following recommend ation from a recent Department of Health review of mental health nursing th at stated: 'The essential focus for the work of mental health nurses lies i n working with people with serious or enduring mental illness'. On the othe r hand, pressure from the primary health care sector suggests the need for services to be provided for the less seriously mentally ill, particularly t hrough the auspices of general practice fundholders. Following a review of the literature, a small-scale, exploratory study was initiated to seek answ ers to the following research question: How is the policy focus urging reor ientation to the severely mentally ill viewed by nurse managers who have a responsibility through Mental Health Resource Centres and Community Mental Health Teams, to provide mental health services? The study was based within a Welsh National Health Service (NHS) Trust that employed six nurse manage rs of Community Mental Health Teams (CMHTs). Four of the managers additiona lly had responsibility for Community Mental Health Resource Centres (CMHRCs ). Of the population of six managers, four composed the sample for the inve stigation. A qualitative research approach was employed, utilizing semistru ctured interviews as the data collection tool. Analysis of the data reveale d that managers were finding creative solutions in order to meet the confli cting demands placed upon them, The research findings also indicated that m any of the obstacles to providing a needs-led service were structural in or igin, and could be resolved by central strategic intervention.