More than a room: barriers and unmet needs of Mental Health Nurse Consultants in general hospitals

Psychiatric comorbidity is common among inpatients in general hospitals, making Mental Health Nurse Consultants (MHNCs) important providers of integrated psychological care. However, evidence regarding the practical barriers affecting MHNC role implementation remains limited, particularly in resource-constrained settings. This study aimed to explore the barriers and unmet needs experienced by MHNCs in Chinese general hospitals. A descriptive qualitative study was conducted at a tertiary general hospital in China in September 2024. Nine purposively sampled participants—including hospital administrators, physicians, nursing managers, and MHNCs—participated in a focus group interview. Data were analysed using descriptive thematic analysis with an independent multi-coder approach, with analytic rigour enhanced through investigator triangulation and reflexive team consensus. Five themes were identified: (1) structural workload and resource constraints; (2) role ambiguity and limited professional recognition; (3) clinical complexity and decision-making strain; (4) relational stress and information asymmetry; and (5) aspirations for role development. Participants highlighted that insufficient protected time, lack of dedicated consultation space, and unclear role boundaries constrained effective care delivery and interdisciplinary collaboration. Despite the recognized clinical value of MHNCs, organizational and structural barriers continue to limit role sustainability and effectiveness in general hospitals. Institutional support, including protected working time, standardized workload documentation, dedicated consultation spaces, and formal integration into multidisciplinary teams, may strengthen the implementation of MHNC services and support high-quality integrated mental health care.