Review of attitudes towards non-medical careers in the NHS: Implications for mental health careers

What are the prevailing attitudes towards non-doctors working in health services, and specifically mental health services? This literature review, commissioned by the National Workforce Skills Development Unit, aims to understand the drivers behind views of non-medical mental health professionals and provides some recommendations for informing future promotional campaigns in order to address the recruitment of students into non-medical careers.

WiIth one in six adults reporting experiencing a common mental disorder and around 1.5 million people referred to NHS mental health therapy services a year, ensuring sufficient staff to meet mental health demand is vital. Yet building this workforce is particularly challenging: there are over 20,000 vacancies across mental health trusts – a higher proportion than any other sector, while mental health workforce numbers have fallen by around 7% in nine years.

This literature review, commissioned by the National Workforce Skills Development Unitaimed to better understand attitudes towards non-medical mental health professions in England. However, given a lack of published evidence on this group specifically, the approach taken instead looked to learn lessons from existing research into people’s attitudes and choices towards all non-medical clinical careers in England and similar health settings. Doctors were not included since medical careers have been the subject of extensive research and attitudes towards them are relatively distinct from other clinical roles.

What did the research find?

Broadly speaking, the literature tended to describe negative attitudes towards non-medical clinical careers. For instance, while many recognise the value in a caring profession and that nursing in particular can be rewarding, these motivating factors were often not enough to overcome the barriers that exist to entering the profession (The Open University, 2019). Our synthesis of the literature identified a range of themes around the attitudes and their determinants, covering the following areas :

  • a person’s background (e.g. gender, skills)
  • their psychological or personal influences (e.g. earlier experiences)
  • cultural or environmental influences (e.g. the media).

Decisions are likely to be influenced by a complex mix of these determinants. However, the relative importance of these influences remains relatively untested and some factors have not been investigated at all.

Most studies looked at small number of determinants rather than across a range but some broader studies drew out the relative importance of the different influences.

One recent survey of young people (18–24 years) who considered nursing suggested the cost of training was significant. 33% cited it as a reason for opting against a career in nursing.

Many also highlighted the importance of working conditions (24% citing working hours and 24% perceived pressure) while few opted against it due to entry requirements (11%) or third party advice (6%) (The Open University, 2019).

Although the influence of gender is covered in some detail, no articles substantively explored the relationship between some key demographic characteristics – such as age, ethnicity, personal circumstances (such as family care commitments) or socioeconomic class – and attitudes and choices of careers.

The research identifies a number of relevant recommendations, including the suggestions to promote positive role models both nationally and locally and to create more opportunities for exposure to the roles.

Download the report to find out more.

Suggested citation

Palmer W, Leone C and Hutchings R (2020) Review of attitudes towards non-medical careers in the NHS: Implications for mental health careers. Research report, Nuffield Trust