Mental health nurse supplementary prescribing: experiences of mental health nurses, psychiatrists and patients

AIM: This paper is a report of a study to explore the views of patients, mental health nurses and psychiatrists involved in mental health nurse supplementary prescribing. BACKGROUND: Medication prescribing by mental health nurses in the United Kingdom is controversial. However, the experience of mental health patients suggests that increasing prescribing capacity could be one strategy to provide a person-centred prescribing approach. METHOD: A qualitative study was carried out in 2005. Semi-structured interviews were conducted with 12 psychiatrists, 11 mental health nurses with prescribing authority, and 12 patients who had been prescribed psychiatric medication by a mental health nurse. Participants were interviewed about positive aspects of supplementary prescribing including the extent of it being evidence-based, person-centred and clinically focussed. FINDINGS: Participants from all three groups had a positive reaction to nurse supplementary prescribing. Mental health nurse prescribing was viewed as evidence-based, person-centred and with an additional focus on physical health. Mental health nurses worked within their levels of competency. Barriers to the implementation of mental health nurse prescribing were nurses' lack of prescribing experience, shortfalls in supervision, insufficient focus on redesigning the service to support the role of the mental health nurse, and preparation for the role. CONCLUSION: Mental health nurse prescribing seems potentially beneficial. However, more rigorous audit and evaluation are needed to confirm its safety, patient satisfaction and health outcomes. Mental health nurse prescribing will require service redesign to ensure that is becomes embedded in the service organizational culture.