• competence;
  • concordance;
  • education;
  • medicine management;
  • prescribing

Accessible summary

  • • 
    Competent mental health nurse prescribers improve medicine management for their clients.
  • • 
    Competent prescribers apply the principles of concordance in action.
  • • 
    Mental health nurse prescribers continue to struggle with the anxiety that prescribing somehow conflicts with the purpose of nursing. Successful prescribers negotiate this.
  • • 
    Becoming a prescriber generates greater understanding of medicines. This is to be expected, but on reflection this increased understanding revealed previously unknown levels of incompetence.


This paper develops an interpretation of the impact of mental health nurse prescribing in the UK. A constructivist-grounded theory methodology was applied to 13 semi-structured interviews with mental health clinicians and service users. The same interpretivist methodology was applied to the literature. Thirty-two practising UK mental health nurse prescribers gave structured feedback on the coherence of the emergent theory. It was found that the theory describes the process of becoming competent in mental health nurse prescribing. This process highlights possible deficits in non-prescribing mental health nurses. It is recommended that if this is corroborated then structured education in medicines management be introduced into pre- and postregistration mental health nursing in UK. The findings of this research offer a framework. That is, the categories emerging within this research translate easily into learning outcomes which can underpin delivery of a consistent medicine management strategy across all levels of nurse education.