Critical Mental Health Nursing: observations from the inside

The argument that propels this emphatic book is that mental health nursing cannot continue to pin the blame for its own actions and failings on the psychiatric hierarchy. As the editors point out, mental health nursing is a degree-level qualification; it has achieved its ambition to be ‘a profession in its own right’. But it has failed to find its own voice and identity or to challenge the coercive, invalidating and traumatising culture and practices within the mainstream mental health services.

It has failed above all to subject itself to its own critical scrutiny.

This is what these chapters set out to do, starting powerfully with an apology from the editors to all the many millions of users of mental health services who have been subjected to the profession’s failure to care: ‘We cannot think of a new knowledge, approach, skill or kind of empowerment that nurses have themselves forged as a “profession in our own right”, of which our service users are identifiably beneficiaries,’ they write.

The editors and several of the 13 contributors to this book are members of the Critical Mental Health Nurses Network, formally launched in 2015. The aim of the network is to provide an identity and forum for shared experience for mental health nurses who are able to admit that the world is far more complex than many would prefer to believe, that people’s messy lives cannot be tidied away into discrete diagnostic categories, and who are, above all, ‘critical’.

Chapters highlight the dilemmas and assumptions encountered daily in mental health nursing practice and ask readers to reflect and challenge them to take collective and individual action to bring about change. Topics include:

• recovery and recovery colleges, written from very different viewpoints
• rooting out the violence culturally embedded within mental health nursing
• nurse education and how to translate theory into ethical best practice
• negotiating the complex pressures of delivering frontline crisis care
• playing the power game within the mental health system
• how the Mental Health Act blocks creative nursing practice
• embedding critical thinking and reflective practice within the profession
• forming political alliances with social movement activists
• the role of social contexts and cultures in shaping mental health and relationships
• mental health nursing as a therapy.

A continuing theme is the ubiquity of coercion both embedded within and perpetrated by the mental health nursing profession. In the editors’ words, it is time for the profession to ‘open new forums... share our honest experiences and fears and, above all, look to all of the places in which imagination has been reignited... [to find] new possibilities that make coercive options fall away.