Advanced practice in mental health nursing

Advanced practice, like many other things in mental health nursing, is an elusive concept and clearly difficult to define. The evidence from this excellent text would suggest that it has relationships with meeting the increasing demands of a worldwide socio-political agenda, professional creativity, responding to the imperatives of research, but above all about providing good practice.

These 14 chapters, written by authors from five countries representing three continents, highlight common threads in the problems confronting the mental health nursing discipline and the enthusiasm for development and innovation which they define as advanced nursing practice. The chapters themselves, while covering diverse aspects of mental health nursing intent, are held together by social awareness and genuine user involvement. Indeed, the book begins with a consumer's view of psychiatry.

This in itself is unusual. Many contemporary mental health nursing texts have addressed the issues of user and carer involvement in services. Unfortunately, such sections are either tagged on to the end of chapters or form the concluding chapter in the book as a whole. By placing the emphasis on users of services from the outset, this book succeeds in reframing the relationship that exists between users and providers of services and the social context in which that care is provided. What is highlighted is that genuine user involvement in services and in decision-making processes covering the provision, delivery and evaluation of care would not have been possible without an awareness of the shifts in social awareness in mental health and civil rights and the critical thinking undertaken by advanced nursing practitioners.

This issue of social context is consistent throughout and enables the reader not only to identify changes and developments but also the underlying causes.

This is particularly evident in the chapters on rehabilitation for people with enduring psychotic illness, and on social skills and social networks for the same patient group. Chapters on therapeutic alliances, community services and supports work well together, providing an insight into the views of users and carers about areas of development.

Chapters seven to 14 deal more specifically with identified diagnoses - for example, depression, child and adolescent psychiatry, older people with mental health problems, personality disorders, suicide and forensic psychiatric nursing. The final chapter acts as a bookend to the first, dealing, as it does, with recovery, mental illness and mental health nursing.

Written by leading practitioners and academics from around the world to create a text aimed at advanced nurse practitioners, the book is intended for masters and doctoral students. I would suggest that it would be of direct interest to both service managers and service providers keen to develop their own expertise.

One gets the impression that the authors felt they were making a difference while being proud of what they have written.

Perhaps this is at the heart of any definition about advanced practice, the ability to take pride in one's work, to see potential for it to have an impact and to feel optimistic that it will make a difference. As Victoria Palmer-Erbs says in her foreword, 'This book succeeds in the ambitious work of identifying common international concerns whilst emphasising the vital role of the psychiatric and mental health nurse'.

I would recommend Advanced Practice in Mental Health Nursing to all mental health nurses wanting to make a difference.

Martin Ward, Director, mental health programme, Royal College of Nursing Institute, Radcliffe Infirmary.