Current context
Whilst the national
rollout of violence and abuse policy in the mental health sector will, no doubt:
o increase the incidence of routine
enquiry of abuse with service users in mental health assessments, and
- improve the care and support that survivors of abuse receive;
it will not fully become ‘core business' until newly qualified clinicians - of all mental health disciplines - enter the field fully equipped to work effectively with survivors on their caseloads. Ultimately, it is the responsibility of all stakeholders in this sector eg o Higher education institutions (HEIs) o Regulatory bodies o Royal Colleges o Regional Deaneries (in relation to psychiatry) o SHA Education Commissioners to ensure, collectively, that all relevant abuse issues are incorporated into pre-registration (and post-graduate) core curricula. It is abundantly clear that, at the present time, this is not the case apart from a few notable exceptions. Ideally, it should be in the pre-registration core-curricula for the education of all NHS professionals. Key educational aspects are:
- the prevalence of abuse in society and in mental health services in particular;
- the impact and consequences of all forms of abuse on the physical and mental health wellbeing of children and adults;
- how to conduct routine enquiry of abuse in assessments and provide a safe context for survivors to disclose;
- appropriate responses to disclosures;
- relevant criminal justice issues;
- the range of ongoing care and support that survivors may need in relation to themselves, to their families and their social and community networks;
- addressing potential student discomfort with regard to sex and sexuality;
- due process in terms of Safeguarding Children and Vulnerable Adults.
This is not all about ‘add on's' to current curricula - although a specific module on sexual abuse is recommended - but incorporating these key issues into existing modules eg diagnostic categories/ presentations/behaviours; relationship building; assessment and care planning; pharmacology; therapeutic Interventions; service user involvement. Revised Nursing Standards for the pre-registration of nurses and midwives (September 2010) Hopefully these will lead to adjustments in the core curriculum that HEIs are delivering to their students to take better account abuse issues. The following is extract for Mental Health Nurses: Standards for Competencies of Mental Health Nurses, Domain 2 Communication and Inter-Personal Skills, 4.1 states: Mental health nurses must be sensitive to, and take account of, the impact of abuse and trauma on people's wellbeing and the development of mental health problems.They must use interpersonal skills and make interventions that help people disclose and discuss their experiences as part of their recovery. http://standards.nmc-uk.org/PublishedDocuments/ Fundamental to this educative process is:
- conveying to students the importance of empowering survivors of abuse and enabling them to work at their pace;
- supporting students who are survivors themselves so that they have the opportunity to address their own abuse issues before they enter the mental health sector.