A new publication from the Royal College of Nursing (RCN)
Tim Coupland, a mental health nurse, leads for the RCN’s Parity of Esteem Programme and part of the Equally Well UK Clinical Advisory Group
I still get asked on a fairly regular basis, “what is parity of esteem?” My initial response, more often than not, is a tendency to begin the conversation with “do you know people with a serious mental illness die 15-20 years before the rest of the population?” Of course, I then go on to describe what the words means, how the term was first coined within a mental health context, and what it actually means in terms of health policy and practice.
Parity of esteem describes the need to value mental health on an equal footing with physical health. Premature death for those with serious mental health problems is tragic and due to a range of complex issues including discrimination, stigma, poor life chances, long term use of medication with severe side effects and lack of knowledge and understanding on the part of staff to name a few. How services are designed also plays a part, as does the lack of adequate funding. In making progress we need to ensure that we provide:
- Equal access to care and treatment
- The same levels of dignity and respect from health and social care staff
- The same quality of physical health care as those without a mental health problem.
The RCN has produced some information, guidance and advice for its members on the subject. The publication is not designed to provide a definitive understanding, but to compliment the growing resources available for NHS staff, service users and in particular the mental health nurses in promoting good physical health. The publication reflects a view that only a collaborative effort will bring about lasting change – it provides an overview of the subject and tells us what our members think is needed to achieve Parity of Esteem. This includes better resources, improved training, and building on areas where we are making a difference. The resource provides a 4 Country UK perspective as well as some really good case studies representing the considerable hard work and effort of mental health nurses in supporting service users’ complex physical and mental health needs together.
The most important contribution of the guidance is what we think the evidence tells us about how mental health nurses can make a difference. Nurses, like all health staff, need to be able to ask important questions to ensure that we are all working collaboratively towards the same goal and this includes promoting partnerships across services, developing specialist support roles and using skills such as coaching conversations to enable others to make positive changes, such as quitting smoking. Most of all, it states a simple yet emerging view from those working on this area within the RCN, that there is one thing that everyone can do, no matter what role they have within health services. This is to develop a habit of enquiring about someone’s physical and mental health needs in the same conversation. So, even if as a health practitioner you don’t feel you can play a big role, there is one thing you can do, one thing that we believe will make a real difference, no matter what setting you work in.
As a member of Equally Well UK, we hope readers find the publication helpful and insightful.