Sunday 8 April 2012

20 Commandments for Mental Health workers

  1. Thou shalt respect your patient and not judge
  2. Thou shalt increase the well-being, opportunities and happiness of your patient
  3. Thou shalt be in time for appointments and phone calls. It will show your patients that they matter
  4. Thou shalt have a well-chosen and well-timed sense of humour
  5. Thou shalt reconsider your ‘professional distance’ if it makes your patient feel he stands alone; show that you are a person too
  6. Thou shalt not let your bad mood or personal issues influence your professional attitude
  7. Thou shalt have an open conversation if your patient is suicidal and give good support and protection if necessary
  8. Thou shalt not hide behind a newspaper or smartphone on the ward or make any other unapproachable impression otherwise
  9. Thou shalt not hide and chat in the nurses’ offices but be with your patients as much as possible to create a safe and friendly environment
  10. Thou shalt consider family and good friends of your patient as team players (unless it’s impossible) and support them well in the interests of your patient
  11. Thou shalt inspire and support your colleagues to make mental healthcare as good and friendly as possible and ask and give feedback on a regular basis to become a ‘winning team’
  12. Thou shalt inform your patient well about side effects of medication, observe well and help to find solutions if needed
  13. Thou shalt not avoid the subject ‘sexual side effects of medication’
  14. Thou shalt help your patient to get good dental and physical care and support them on doctor and dentist visits if needed
  15. Thou shalt help and support your patient to exercise on a regular basis to increase their health and give support to decrease smoking.
  16. Thou shalt support your patient to overcome financial or housing problems and fight bureaucracy
  17. Thou shalt listen well to the patients' aspirations for their life and give support to achieve them
  18. Thou shalt stand up for the rights of your patient
  19. Thou shalt fight the stigma of mental illness at every opportunity
  20. Thou shalt help your patient to keep up hope

 © Nursewithglasses 2012-2013


  1. Well done for writing these. And well done for finding time in your busy work schedule, & with your father's health problems, to set up a blog.

    I hope your 20 Commandments will be printed off & given to ALL healthcare staff, as they have wider appeal than mental healthcare.

    They would certainly have made a difference to my experience of mental healthcare if they'd been implemented on ward and by the community mental healthcare team.

    Well done again.

    1. If only All CPNs followed these rules life wouldn't be so scary. Some times the MH professional is the only person some people have to talk to in a week. Also, can you add "stop trying to run away from your client" as we already know we are a burden!

  2. Came here via Twitter - Sue Marsh's tweet. Love these commandments! They should be seen by ALL nurses, not just Mental Health Workers. If this stuff was taught to nurses I might have had more help when my parents were sick and demented. (sorry for rant there) Thank you so much for your efforts on behalf of those who can't sort stuff out for themselves. My very best wishes to you from Liverpool, Maggie.

  3. Hi NWG,
    Great post - hope there's another soon!
    Several points ring true as I deliver STORM training this week. As a further post I wonder if you could map these onto Hodges' model?

    I champion this conceptual model that may be of interest to you and your readers? The model is introduced through a website and blog -

    Originally created in the UK by Brian E Hodges (Ret.) at Manchester Metropolitan University - Hodges' Health Career - Care Domains - Model [h2cm]

    - can help map health, social care and OTHER issues, problems and solutions. The model takes a situated and multi-contextual view across four knowledge domains:

    * Interpersonal;
    * Sociological;
    * Empirical;
    * Political.

    Our links pages cover each care (knowledge) domain e.g. INTERPERSONAL (which inc. mental health, therapies, psychology...):


    Best regards NWG,

    Peter Jones
    RMN, RGN, CPN(Cert), PGCE, PG(Dip) COPE, BA (Hons.).
    Community Mental Health Nurse for Older Adults,
    Independent Scholar and Informatics Specialist
    Lancashire, UK
    h2cm: help 2C more - help 2 listen - help 2 care

  4. Hi Peter,

    Thanks for your comment. Will check out the Hodges Model.Just posted a second blog yesterday :)

  5. Hi
    Thanks for the inspirational post. I have linked to it on my blog. All the best, Louise

  6. this is very amazing, it goes hand in hand with what we are trying to input in our mental health care bill here in Kenya read and follow me @sitawaWafula on Twitter tomorrow as we discuss this with other stakeholders.

  7. Wow, it sounds as though you have many caregiving roles, both personally and professionally! I'm sure your partner was very grateful to have your support for that scary experience. I love number 19. As a mental health worker (social worker) I try to address stigma on a daily basis - even if just in small informal conversations with people. If you ever want to chat stigma I'm @alliancecounsel.

    Remember to take are of yourself while you take care of others. If you want any information or direction on good books for compassion fatigue please feel free to email me at

    All the best!

  8. I love these...may I share them with some colleagues?

    I read in the above comments that your father has had a stroke...I hope that he is doing well, and that you are taking care of yourself as you take care of him. I've had a stroke myself, and I know that we can be a demanding bunch...

  9. We are mental health advocates in Victoria British Columbia Canada. Good for you for putting out to others your words of wisdom to those who can make a difference in citizen's lives who have mental illness. Follow broadpowers@Twitter

  10. Really enjoyed this article and have shared with my followers, this could also apply for people working within the care industry. Thanks for writing this blog.

  11. Perfecto! Nos sumamos a la iniciativa desde Tenerife (Spain).
    Blog Saltando Muros
    Twitter SaltandoMuros
    Facebook Proyecto Saltando Muros

  12. This reminds me of the aims of a mental health unit I worked at in the New Forest, Hampshire, UK. Sadly, Woodhaven has now closed due largely to spending cuts. Hopefully the team will be able to spread good practice to other units.

  13. I am always amazed by mental heath projects as they always say and do so much for mental health. Yet I use another kind of community whereby we are also discriminated and constantly stigmatized by either ignorance and fear. Yes the community I am talking about here is the HIV community.

    Those commandments are in fact useful for any or all communities that have ever been treated very differently from other communities.

  14. You should also encourage therapists to adandon the once a week for 50 minute treatment paradigm as completely ineffective. You need a lot of counselling in a short period of time to make a real difference in clients lives. The dirty little secret in the counseling industry is that they have an average failure rate of 75% because of their obsolete treatment paradigm.

  15. Couple of more things: I hate it when mental health organizations call me a "consumer" as if my medications and other therapy were like iPods and other materialist drek. I use these things because I have a mental illness, so call me a patient or a client instead.

    Another thing is to stop saying that I can recover from mental illness. It is here to stay. But what I can develop is resilience so I can bounce back from episodes more quickly and for longer periods of time.

    And please don't get on my case if I choose to call myself "bipolar" instead of "a person living with bipolar". I have enough on my plate when I am in crisis than to worry about the choice of words that I use to identify myself. I haven't had an episode since 2007 -- seems like it doesn't matter if I call myself a bipolar. I know people who avoid the term who are in and out of the hospital. Comedian David Granier has a nice come-up to this: "I'm not an asshole. I'm a person living with an asshole." See how silly it sounds?

  16. Hey thanks nurse with glasses and I hope it's not a problem if I re-post it on my blog, with a link to your blog. I sincerely want to share this with my readers. This is something that every nurse not only mental health workers, should follow. Thanks again.

  17. Great list of commandments iit's just a shame this doesn't happen anyway. They seem like basic humane treatment of people to me. Why should caring professional so called educated people need a list like this. As we all know, sadly they do, thanks for putting it out there.

  18. Fantastic commandments, if this were used as a competency framework fir mental health nursing I'm sure care standards and health outcomes would improve massively. As a 'service user' and nhs worker I think these are great x

  19. Hi! I've not long come across this post and it's brilliant. I hope you don't mind but I've made a blog post about it (with a link back to this post).

  20. These commandments are amazing in that they are real and achievable. It's a shame not all mental health workers follow them.
    If you read my blog you will see that they don't.
    Maybe I should print them and give them to my MH team?

  21. No tru'er word were spoken!

  22. And thus spken Satan against God and forth from his nether bowels came the 21st Commandment.....

    And thou shalt achieve all this in five minutes of patient contact and be held accountable....

  23. One the "commandments" for every legitimate medical specialty is "thou shalt not impose treatment." This does not hold true for psychiatry, which routinely imposes coercive treatments. The rationale is that forced treatment helps people, even saves lives. But a person with a physical disease can refuse treatment even if the treatment would save his life. Without coercion there is no "mental health" industry.

  24. i just came across this! thank you, i hope someday the majority of mental health workers will think this way.

  25. Thank you so much for 20 necessary & powerful reminders to all Mental Health Workers! It is my hope that they remember them and incorporate them in their practice. Peace of Mind & Love to You! Nana

  26. Thank you for the 20 commandments. I am a Training Officer at an inpatient facility. I will share these with my colleagues. I will also teach them in the new employee orientations I conduct and post them on the units. Thanks again. I'm pleased to know I'm not alone in my views about treating people with a diagnosis. #madinamerica

  27. An excellent list; from a mental health service user's perspective, I'd like to add:

    Thou shalt not disbelieve the victims of othering because their experiences are 'unlikely'.

    Thou shalt not use New Age nonsense instead of tried and tested therapies.

    The former problem has held my life back considerably; therapists need to 'check their privilege' and realise that attacks on vulnerable groups are commonplace, not rare.

    The latter is important because NHS money is being used to promote New Age stuff such as Enneagram testing that looks and sounds like Astrology but with numerology used instead of star signs; in other words, it's complete nonsense. Someone close to me, along with other vulnerable people in a group situation, had to challenge the therapist's methods and things became very difficult - not good in a situation where trust is paramount.

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