title: Knowledge, confidence and attitudes towards mental health of nurses working in NHS Direct and the effects of training.
abstract: BACKGROUND
  NHS Direct, the United Kingdom's 24-hour nurse-led telephone advice service, was announced in December 1997. By November 2000 the service was available throughout England and Wales. Initial research had shown that people with mental health problems used the service and that, prior to its going live, this was one area about which nurses felt least confident.
  
  
  OBJECTIVE
  The aim of the study was to measure confidence in dealing with mental health calls, knowledge of mental health issues, and attitudes to mental health before and after training.
  
  
  METHODS
  A postal questionnaire was sent to all nurse advisers working in 17 NHS Direct sites in England before and after mental health training had been received. The questionnaire was designed to measure confidence, knowledge and attitudes. This was done through scenarios of real calls to NHS Direct, questions from the World Health Organization guide to Mental Health in Primary Care and the Depression Attitude Questionnaire.
  
  
  RESULTS
  Confidence increased in nurses who received mental health training. Although there was no statistically significant increase in knowledge scores after training, those who had received training increased by on average one point. After training, attitudes towards depression had shifted in that nurses now felt more positive towards their role in treating depressed patients.
  
  
  CONCLUSIONS
  Training in mental health can lead to increases in confidence and a change in attitudes and would be beneficial for all nurses working in NHS Direct and in other primary care fields. It would also be beneficial to repeat the study with a larger number of nurses and after a longer period of time to assess the long-term effects of training.
authors.affiliation: Immediate Access Project, Department of General Practice, Guy's, King's and St Thomas' School of Medicine, London, UK. fipayne@hotmail.com
authors.forename: Fiona
authors.initials: F
authors.lastname: Payne
authors.forename: Kate
authors.initials: K
authors.lastname: Harvey
authors.forename: Lynda
authors.initials: L
authors.lastname: Jessopp
authors.forename: Sue
authors.initials: S
authors.lastname: Plummer
authors.forename: Andre
authors.initials: A
authors.lastname: Tylee
authors.forename: Kevin
authors.initials: K
authors.lastname: Gournay
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D002983:Clinical Competence / Q000592:standards*; D003419:Crisis Intervention / Q000193:education; D004509:Education, Nursing, Continuing / Q000458:organization & administration*; D004739:England; D005163:Factor Analysis, Statistical; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D015277:Hotlines / Q000458:organization & administration*; D006801:Humans; D008297:Male; D015402:Nursing Education Research; D009740:Nursing Staff / Q000193:education* / Q000523:psychology* / Q000592:standards; D011287:Prejudice; D015397:Program Evaluation; D011568:Psychiatric Nursing / Q000193:education* / Q000592:standards; D020377:Self Efficacy; D013222:State Medicine; D011795:Surveys and Questionnaires; D014852:Wales