Quote from LilaDavis
Where I am now there's a big push toward community treatment/crisis 'cafes'/day centres in order to keep people OUT of hospital as much as possible, which I wholeheartedly agree with. But these programs seem to be staffed primarily by psychologists and techs. At the same time I'm sure there will always be those too ill to be nursed at home. I think I just worry sometimes about the outlook.
What are your thoughts?
I personally am not a fan of the deinstitutionalization movement - mainly because although I understand the necessity of it, some places are overly zealous about it and the community treatment model doesn't work for everyone. States and counties rave about how they're helping people integrate into the community but generally it just turns in to "We closed a bunch of units and are saving money, Yay!" without the installation of community facilities and services for the clients who are now back in the community. The general trend I've found (now, I work predominantly corrections and jail - so I probably have some confirmation bias here) is that, as institutions close and bed space in the remaining inpatient units and state facilities gets overwhelmed there tends to be a direct correlation with incarceration rates of psychiatric patients (as they fall through the cracks within the community). Basically, making the jails and prisons into the new psychiatric institution, sadly.
To that end - I don't see psychiatric nursing going anywhere. Personally, I dislike the corporate healthcare culture of the hospitals and shy away from them - and have never had a difficult time finding a psychiatric nursing position outside of the hospital. With the push for community care you have Assertive community treatment teams, Psychiatric emergency response teams, Psychiatric Emergency departments, case management, correctional psychiatry (Jail & Prison) as well as state hospital psychiatry (The community might rally to get them closed however, at least in my state they're never able to do so because that same community isn't comfortable when they try to set up a group home for violent sexual offenders in their neighborhood - go figure) and many other options available.
I wouldn't worry about job prospects in mental health overly much - there are many people that require mental health services (and that number is not diminishing) and there are more places for psychiatric nurses than in the hospital setting.