Dr Caroline Laker

Senior Lecturer in Mental Health

Faculty:Faculty of Health, Education, Medicine and Social Care

School:School of Nursing and Midwifery

Location: Chelmsford

Areas of Expertise: Nursing and midwifery

Research Supervision:Yes

Caroline is a qualified mental health nurse and lecturer. She has research experience in the field of implementation science.  She uses her front line experience to inform her teaching and research activities. Her areas of expertise are Mental Health, Implementation Science, the impact of the work setting on nursing perceptions (barriers to change, ward climate, work satisfaction, stress, burnout, resilience).



Caroline’s clinical and academic background is in acute in-patient mental health settings and research. She is interested in developing pragmatic, real-setting research and has used her front line experience to inform her research activities. For her PhD, she explored the relationship between change and those involved, by developing a measure of staff perceptions of barriers to change (VOCALISE) from the perspective of acute mental health in-patient nurses. The goal was to explore whether using nurses’ perspectives in measure development produced a more relevant, usable and concise measure.

How staff perceived and responded to an innovation was then explored through a randomized controlled trial to implement nurse-led psychological therapies on acute in-patient wards. Caroline investigated whether a period of transition (change over 12 months) had negative impacts on the perceptions of mental health ward nursing staff, using VOCALISE and additional measures of perceptions of ward climate, work satisfaction and burnout. The aim was to examine the emotional and psychological health of the workforce in relation to planned change, as well as their response to a challenging ward climate. The purpose was to clarify where support is required for staff to successfully implement improvements in these complex settings, given embedding meaningful changes will enhance patient outcomes.

Research interests

  • The relationship between staff and service users perceptions in mental healthcare
  • Communication pathways within organisations
  • Staff empowerment within organisations: the effects of participatory research 
  • Staff well-being/morale/resilience/burnout

Caroline’s research has shown that organisational innovation/change has an emotional/psychological impact on nursing staff working in mental health wards. Given that nursing students are the future of the NHS, it is important to encourage thinking about how real setting/organisational challenges can be addressed to promote improvements. It is clear that building resilience and a strong professional identity, as well as promoting optimism will be important in developing a healthy workforce.


  • Mental health Nursing Pre-Registration
  • MSc Mental Health


  • PhD – Overcoming barriers to change: the effects of staff perceptions: Institute of Psychiatry, Psychology and Neuroscience, King’s College, London
  • BSc (hons) – Mental Health Nursing Studies: Institute of Psychiatry, Psychology and Neuroscience, King’s College, London
  • BA (hons) – English Literature: Royal Holloway, University of London

Selected recent publications

Laker C, Cella, M. Callard, F, Wykes, T (2018). Why is change a challenge in acute mental health wards? A cross-sectional investigation of the relationships between burnout, occupational status and nurses' perceptions of barriers to change. International Journal of Mental Health Nursing. [doi: 10.1111/inm.12517 - Epub ahead of print]

Rose D, Evans J, Laker C, Wykes T. (2015). Life in acute mental health settings: experiences and perceptions of service users and nurses. Epidemiology and Psychiatric Sciences: 24(1):90-6.

McCrae N, Askey-Jones S, Laker C. (2014). Merely a stepping stone? Professional identity and career prospects following postgraduate mental health nurse training. Journal of Psychiatric and Mental Health Nursing. 21(9):767-73.

Laker C, Callard F, Flach C, Williams P, Sayer J, Wykes T. (2014).  The challenge of change in acute mental health services: measuring staff perceptions of barriers to change and their relationship to job status and satisfaction using a new measure (VOCALISE). Implementation Science 20: 9(1) 23

Laker C, Rose D, Flach C, Csipke E, McCrone P, Craig T, Kelland H, Wykes T (2012). Views of the Therapeutic Environment (VOTE): stakeholder involvement in measuring staff perceptions of acute in-patient care. International Journal of Nursing Studies. 49(11):1403-10.

Laker C, Flach C, Gray R (2010). Case study evaluating the impact of de-escalation and physical intervention training. Journal of Psychiatric and Mental Health Nursing. 17(3): 222-228.

Laker C (2008). A literature review to assess the reliability and validity of measures appropriate for use in research to evaluate the efficacy of a brief harm reduction strategy in reducing cannabis use amongst people with schizophrenia in acute in-patient settings. Journal of Psychiatric and Mental Health Nursing, 15(9): 777-783.

Laker C (2007). How reliable is the current evidence looking at the efficacy of harm reduction and motivational interviewing interventions in the treatment of patients with a dual diagnosis? Journal of Psychiatric and Mental Health Nursing. 14 (8): 720–726

Laker C. (2006). How successful is the dual diagnosis good practice guide? British Journal of Nursing 15 (14): 787 – 790.