Psychosocial interventions for older people experiencing voices, visions and unshared beliefs: a dedicated nurse role in Wales

In 2020, a clinical nurse specialist (CNS) role dedicated to older people experiencing voices, visions and unshared beliefs (VVUBs) – often termed ‘psychosis’ – was created in the Mental Health Services for Older People at Cardiff and Vale University Health Board. One of the drivers for this new role was the wish to shift from a biomedical approach to a trauma-informed, human rights-focused biopsychosocial approach. The author is convinced that mental health nursing should reduce the over-reliance on the biomedical model and revise how it approaches extreme mental and emotional distress. This article examines how the CNS role was established and how it can support this cultural change through role modelling and staff training. It discusses the importance of the therapeutic relationship and the significance of the language used to describe altered states of consciousness such as VVUBs. Since the role was created, service users have gained better access to trauma-informed psychosocial interventions.