Mental health staffing crisis

Mental health workers 'are demoralised'

Mental health services cannot deliver the targets set by government, according to a report.

The study, by the Sainsbury Centre for Mental Health, says the service is understaffed and under tremendous pressure.

Psychiatry

In 1998, 14% of consultant psychiatry posts were vacant or filled by locums

There was a 32% increase in unfilled consultant posts between 1995 and 1998

More than a third of NHS trusts reported difficulties in employing psychiatrists

It says the targets set out in the National Service Framework will remain a pipedream without significant new investment and a clear, coherent national strategy for recruitment and retention of staff.

The report, "Finding and Keeping", finds:

• short-term measures to cope with understaffing, such as the use of agency staff, are expensive and destabilising
• staff are being demoralised by increased bureaucracy, the risk of violence and grim workplaces
• burnout and worrying levels of pyschological stress are increasingly common
• lack of a clear management strategy leaves team confused about who is in charge and who does what

The report calls for better leadership and support for staff, including more incentives to encourage mature people to stay within the field.

Many trusts have a high proportion of staff in their 50s.

Nursing

85% of trusts reported difficulties in recruiting and retaining mental health nurses

1n 1998, nearly a quarter of mental health nurses were aged 45-55

The authors say they found it difficult to pinpoint the exact scale of the recruitment problem as little standardised information was available on vacancy levels.

Serious shortage

Sir Graham Hart, chair of the independent health think-tank, The King's Fund, who chaired the review, said: "What we do know is that there is a serious shortage of well-trained staff across all the main professions, which has an obvious impact on the provision of high-quality services."

Matt Muijen, director of the Sainsbury Centre, said: "There are skilled and talented staff working in mental health services - but not enough to go round.

"By making sure that we nuture and develop existing staff as well as attracting new ones, we will begin to unlock the huge potential in mental health services, and that's going to be good for patients as well as staff."

The study highlighted a 1995 survey that found 54% of social workers in community mental health teams were emotionally exhausted.

It also highlighted a 1997 survey that showed a 10.2% vacancy level for full time occupational therapists and a 15.1% turnover rate.

The National Service Framework for Mental Health sets seven national standards for mental health services.

The aim is to drive up quality and reduce variations in services to patients and service users.

It will include round-the-clock crisis teams for emergencies, more mental health beds and improved training for GPs.

Ministers also want to close a loophole which means dangerous psychopaths who are considered "untreatable" cannot be locked up unless they commit a crime.

The framework is backed by government funding of £700m over three years.