A dire shortage of registered mental health nurses in England means that staff struggle to focus on therapeutic care, according to an expert witness at the country’s first mental health inquiry.
He said that current staff are so scared of being blamed for things going wrong that they’ve lost all empathy for patients – that there were 13 000 vacancies for mental health nurses in England in 2023, with a 26% reduction in applications.
Consultant psychiatrist Dr Ian Davidson, who was giving evidence last week at the Lampard inquiry, which is probing the deaths of 2 000 patients in Essex from 2000 to the end of 2023, said a “culture of fear” had developed and that staff felt as if they would get criticised, whatever they did.
Essex Partnership University NHS Foundation Trust (EPUT) has apologised to those affected, reports the BBC.
Davidson gave the example of a community mental health team, trying to manage waiting lists.
“To see more people, you then have to discharge more people, but if you discharge someone and something goes wrong, you get blamed for that,” he said.
“If you don’t discharge people and try to increase your caseload, then your time per case goes down. So, if then something happens because someone didn’t get a visit for several weeks, you get blamed for that.”
He said if staff were being asked to do four or five different tasks at the same time, their ability to have a clear focus on each person reduced.
“Every human being has … a limited ability to be compassionate and empathic. The more stressed… the more we are rushed off our feet, the less time to think or to provide a compassionate response.”
The psychiatrist of 23 years also said a lack of resources led to a “very defensive focus”, which included staff writing notes to explain that failures were not their fault.
‘Compassion fatigue’
“If you have maybe six or seven staff on a ward and one or two registered nurses, the ratio is very heavily on the 14 healthcare support workers,” he said.
He told the inquiry this led to “compassion fatigue”, where staff were distracted and not fully engaging with patients.
A second expert witness, former Chief Nurse Maria Nelligan, said there were times during the past 25 years when “there was an emphasis on reducing costs and healthcare support workers are cheaper than registered nurses”.
The government said it was due to unveil a new NHS staffing plan this year, and that alongside “reform and investment”, it would ensure it had the “right workforce at the right place, at the right time”.
Baroness Lampard, the chairwoman of the inquiry, will hear evidence across several sessions until October 2026, with her report likely to be published in 2027.
BBC article – Inquiry told of ‘culture of fear’ in mental health (Open access)
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