New roles for nurses as approved mental health professionals in England and Wales.

This paper critically discusses the challenges mental health nurses face in trying to achieve a balance between fulfilling biomedical and social roles. We suggest that dilemmas exist for nurses in attempting to combine both approaches in their practice. We present a specific example of these as occasioned by the advent of the approved mental health professional role in England and Wales. This statutory role requires the adoption of an independent social perspective as a counterbalance to the biomedical perspective brought by psychiatrists. Using the idea of occupational jurisdictions we discuss how nurses embarking on this new role are effectively crossing into territories previously occupied by the profession of social work. We also reveal the tensions for nurses who fulfil the approved mental health professional role whilst simultaneously carrying out work in other areas which demands a more overtly biomedical approach. We review critical accounts of the validity of bio-psycho-social models and concerns about maintaining positive therapeutic alliances alongside making applications for compulsory detention, assessment and treatment. We argue that the new role may become part of the professional project of mental health nursing, but also present challenges in helping redefine nursing's identity and practice.