Outcomes associated with skill mix interventions in acute mental health wards: a synthesis of evidence

The costs associated with staffing acute mental health wards is the largest expenditure in the inpatient budget. Exploring skill mix and its impact on outcomes, particularly service user outcomes should be of interest to all stakeholders involved in the commissioning, delivery and receipt of acute mental health care. This paper describes the findings of a literature and practice review of initiatives undertaken to improve staffing and skill mix, and their impact on service user outcomes. The practice review was necessary due to the paucity of published research in this area. Both research and practice initiatives do not appear to be driven by service user need. This results in a restricted and service driven range of outcome measures being used. The paper concludes by proposing recommendations for future workforce development in acute mental health settings.