‘Changes
must be made in order that in-patient admissions serve any purpose other
than as holding bays.’
‘People
would recover quicker and go home sooner if conditions were improved and
dignity retained.’
‘In
the absence of crisis support it kept me safe but it was a traumatic
experience.’
Mind's survey
into the un-therapeutic environment of modern psychiatric wards - the
charity's largest survey of ex-patients` views of conditions on
psychiatric wards in England and Wales for more than a decade - reveals
that they have a negative effect on patients' mental health. The report,
Environmentally Friendly? is based on a survey of 343 people who had
recent experience of psychiatric wards.
The survey's
findings highlight that good practice on some wards was not common to all
wards. The atmosphere on many wards was depressing; decoration was basic;
there was a serious lack of staff contact with patients; access to food
and drinks was often denied; illegal drugs were being used on the wards.
Mind says that
psychiatric wards have long been the poorest relation in the health
service, and the charity will be calling on the Government and Mental
Health Czar to implement recommendations that would significantly improve
ward conditions. Mind's Chief Executive, Judi Clements, said: ‘We need
major improvements if we're to have wards suitable for the 21st
century. Hospitals will always be an essential part of modern psychiatric
services, so it is vital that we have wards that are safe and supportive
with therapeutic environments, and that good practice on some wards is
shared by all the others across Britain.
‘Basic décor
and furniture create a bleak and depressing atmosphere, and restricted
access to the kitchens to make snacks and drinks make the wards feel more
like holding bays than homely environments that aid recovery. People need
to feel safe and supported in every sense.
"Someone in
acute mental distress needs more than 5 or 15 minutes with staff each day
to talk about their problems. Some staff are very supportive but others
are not," said Judi.
-
More than half (56%) of
patients said the ward was an un-therapeutic environment, more than
double those who said it was therapeutic (25%)
-
Just under half (45%) said
the ward conditions had a negative effect on their mental health. 27%
said it had a positive effect
-
More than half (57%) of
patients said they didn't have enough contact with staff. The majority
(82%) of these said that they had 15 minutes or less with staff each
day.
-
Just under a third (30%) of
patients said illegal drugs were being used on the wards. Two thirds
of these patients (66%) said that the drugs were easily available to
patients
-
Almost 1 in 6 (16%) of
patients said they had experienced sexual harassment on the ward
-
Almost two thirds (60%) of
patients had problems getting a restful night's sleep
-
Just under half (45%) of
patients said they didn't have enough access to food, and 31% of
patients said they didn't have enough access to drinks.
Environmentally Friendly? – recommendations of the report
-
More genuine and meaningful
consultation with users of mental health services, eg through the
setting up of user panels, to make recommendations for change and to
monitor the day-to-day operations in psychiatric wards.
-
Regular monitoring and
reporting on implementing quality aspects of the NHS Plan on a
trust-by-trust basis to ensure that user and carer views have been
sought on the services they receive. This can include issuing an
annual prospectus setting out standards, performance and the views of
users and carers. Collection of the views of users and carers can be
through regular satisfaction surveys designed in conjunction with
users.
-
Clinical improvement targets
to be part of clinical governance development plans, to include a
focus on improvements in safety for all patients; the condition of the
psychiatric ward environment; patient satisfaction in terms of food,
drinks and exercise; the quality of communication. This can be carried
out, in part, through monitoring the implementation of recent guidance
to health authorities and trusts on cleanliness in hospitals.
-
Monitoring and reporting on
the implementation of national standards of good practice. The
National Service Framework for Mental Health calls for strengthening
the evidence base by obtaining user's views, setting local and
national milestones, systematic review and performance management.
-
Development of workforce
planning to establish a baseline staffing profile; to ensure that
education and training takes account of needs and issues from users’
perspectives; to encourage flexible recruitment and retention aimed at
building a diverse workforce; and to ensure an appropriate skills mix.
Regular, accessible reporting from the Modernisation Action Team on
the Professions would be welcome.
-
Input by service users into
core staff training.
-
A national action plan for
tackling illegal drugs on the wards, and ward policies that encourage
people to admit drug use so that they can receive appropriate
treatment where necessary.
-
A plan to deliver greater
access to interpreters for those who need them – a need recorded by
the Provision of NHS Mental Health Services, Fourth Report of
the Health Committee and accepted by the Government's response to the
Committee.
-
A legal right to advocacy to
be incorporated into the new Mental Health Act.
-
Improvements in information
provision to in-patients. Where facilities are available to
service users – such as advocacy, organised activities or access to
drinks – they are not always made known to them. All patients should
be provided with information so that they can make full use of the
rights they have.
