Community Psychiatric/Mental Health Nursing: Contexts and Challenges—The Case of Nurse Prescribing and Recovery-Focused Interventions

This chapter focuses on the role of psychiatric/mental health (P/MH) nurses who work in community settings. The chapter retrospectively reviews the stated and implicit aims of mental health services and what has driven the changes that have taken place across Europe in the last 50 years, moving from a heavy reliance on institutionally based services to varying degrees of community-based care. The role of P/MH nurses within these changes is explored, using P/MH nursing in England as a ‘case study’, particularly the growth of the so-called ‘Advanced’ nurse prescribing role within England. Nurse prescribing has been adopted, to some extent and to a certain degree, some by countries across Europe. It is perceived by some as allowing P/MH nurses to practise with a more holistic, recovery and service user focus, conversely by others as replicating undesirable medically defined models of care. It is argued that all changes in mental health services are perceived through multiple perspectives, dependent on philosophy, profession and personal circumstance. The development of P/MH nurses as prescribers of medication is an example where different perspectives are starkly brought into focus. The emerging evidence is reviewed and tentative conclusions drawn