With profound changes in the use of medical staff, there could be significant changes to the role of nurses. In the UK, mental health nurses form the backbone of services, acting as frontline carers, and commonly offer 24 hours a day, 7 days a week care. There are over 45,000 mental health nurses in the UK.8 This reflects the fact that mental health nurses work in all areas of mental health services, and frequently act as care coordinators. For many people, nurses are the only direct care providers, although their role is increasingly being taken over by unqualified 'support workers'. Their extended and close contact with service users means that it is often only a nurse that has a detailed knowledge of the individual, their carers and families. In the psychosocial vision I am offering, mental health nurses could further develop competencies in psychosocial interventions.9 The model of service provision I am proposing would support the development of the autonomy and independence of nurses in a 'consultant' role, and strongly support the development of nurses' competencies in psychological aspects of care and in psychological interventions. In recent years, the role of the mental health nurse has already evolved in this direction, but there is a convincing argument for a substantial change in the nature and profile of the nursing role. I believe that the training of 'nurses' should reflect the science of mental health care; and should stress psychosocial, not medical interventions. I would much prefer to offer my colleagues training in new approaches rather than to argue that we should replace them. We should even consider changing the name of the profession to reflect its new emphasis. The 'nurse' role and title again stem from healthcare, from medicine and could be argued to be inappropriate in a psychosocial service. Although likely to be controversial, renaming 'nurses' might be a very powerful way to signal change in the system. Of course, it would be for my colleagues to define their own identity, but a possibility would be something like 'psychosocial therapist'.

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