Mental health nurses work in a variety of settings with service users and their carers. There are some 57,000 mental health nurses working in the NHS, who aspire to do their best to support the recovery of people who experience mental health problems and assist them in maximising their potential.

In recent years, mental health services have often been focused upon for all the wrong reasons. This has begun to change as mental health services have become recognised as a priority and found themselves in the limelight. This is generally good news, which has been broadly welcomed by those who use mental health services and the nurses and others who work with them.

The National Service Framework for mental health has outlined the government's strategy for improving mental health services over 10 years and underpins the vision of service change and plans for modernisation. The mental health aspects of the NHS Plan and a raft of subsequent strategies have embellished the framework with proposals designed to build better and more cohesive services. These include attention to workforce matters, the prevention of suicide, the needs of black and minority ethnic service users and more besides. A significant aspect is the current drafting of a new legislative framework for mental health, about which many stakeholders share considerable concern. The current modernisation of mental health services is being shaped and implemented with varying speed in each of the four UK countries.

The RCN's mental health nurse members are, in general, pleased to find that mental health care is now declared a priority. However they do hold concerns within what they perceive to be something of a maelstrom of change.

Nurses accept that change to such a neglected array of services will take time. They also express the view that despite the blizzard of policy proposals, which arguably contain many sound ideas, little has yet been witnessed in terms of generalised service improvement or the release of the funding which was heralded to support implementation. This dislocation between vision and reality - described by some as "long on bluster but short on results" - leads to a decrease in morale amongst mental health nurses. Struggling to implement new requirements and respond to managerial calls to provide pre-implementation information nurses find that the time they have to spend with service users and carers is further diminished, for which, in turn, they are criticised. Promises of jam tomorrow may not be enough to retain the mental health nurses who soldier on in the face of considerable challenges or ease the recruitment problems which nursing experiences. Attention to the pay of nurses and the early release of the much-promised millions to develop new services are therefore urgently required.Mental health nurses are the largest contributors to the mental health service workforce and they should be valued and supported for the contributions that they bring to users' care and support. Demonstrating this by providing better working conditions, access to meaningful continuing edudition to its policy implementation guidance which encourages improvements in such settings. Whilst much can be done by innovative mental health nurses and their colleagues to drive the recommendations into practice, there is no question that financial investment will inevitably be needed to turn around this most neglected area of mental health care.

Many in-patient settings have poor environmental conditions and staff shortages and are over-occupied by acutely ill people - some of whom experience additional problems brought about through substance misuse. In these settings violent incidents can frequently occur. This understandably generates fear amongst the users of these services and the nurses who are often the casualties of such violence. Many nurses feel that little is being done to address this issue in terms of prevention, dealing appropriately and robustly with the perpetrators and ensuring that high quality support is provided for nurses who have experienced such an assault.

It may seem harsh to present a catalogue of issues which portray the challenges that have yet to be overcome and restate the familiar monetary messages. If users and mental health nurses who work with them are to enjoy the benefits that ensue from the provision of safe, sound and supportive mental health services there is no sense in pretending that these will be developed on the cheap.

Mental health nurses are of course doing many good things, advancing their practices, developing new skills, implementing new ideas and working in alliances with users, carers and colleagues to improve mental health services across the United Kingdom. The mental health nursing forums within the RCN are continually active in supporting mental health nurses, lobbying for further improvements in mental health care and contributing to the development and shaping of policy.

There are countless examples that could and should be showcased which demonstrate the deep commit-ment of mental health nurses to find ways of bringing about improvements. Examples can be found in the recent inpatient policy guidance, which portrays how nurse-led initiatives in Bradford and Brixton have radically improved inpatient settings. In Newcastle it is shown that when the commitment of staff and the meaning-ful involvement of users is combined and then applied, in a ward that has been recently built and is fit for purpose, the service can become an area of good practice.

Elsewhere nurses are cutting new ground as they begin to implement new ways of working in teams which seek to enable users to receive treatment at home, ensure that they enjoy good quality follow up care or can access evidence-based nursing practices and interventions in primary care and other settings. Nurses are working more closely with other individuals, teams and agencies and taking up the mantle of leadership within new organisational structures. There are now over 60 nurse consultants in mental health settings in England and they are contributing to nursing research, practice development and the education of others. Developments in nurse prescribing will offer new opportunities to be taken, by those mental health nurses who wish to embrace them, and contribute to improved care arrangements for users. The anticipated results of the reforms to mental health legislation - about which, it must be restated, many nurses still hold many deep reservations - will also draw nurses into activities which have been hitherto conducted by colleagues from other professional groups.

RCN mental health nurses look forward to a time when all stake-holders can view mental health services with pride, when they fully reflect the wishes of users, are properly funded and co-ordinated, and allow the art and science of mental health nursing to achieve the full richness of its potential. They, and Dr Beverly Malone, the RCN's General Secretary and herself a mental health nurse, will continue to work in partnership with others to realise these goals.