More than half of psychiatric inpatients verbally or physically threatened by other patients or staff, survey reports

September 6, 2004
by Adam James

More than half of psychiatric inpatients are verbally or physically threatened by other patients or staff when in hospital, a survey by the mental health charity MIND has found.

More than a quarter (27 per cent) of inpatients who took part in the survey of 335 patients said they rarely felt safe while in hospital. More than half (54%) thought their stay in hospital had not helped their recovery.

The Ward Watch report, to be launched tomorrow, will not make comfortable reading for mental health managers. However, the survey's validity will be questioned due to its small sample.

The report lists examples of a patient urinating in another patient's room, a patient getting dragged up stairs by nurses, and a voluntary patient being threatened with a section by a psychiatrist.

The charity's report - a copy of which psychminded.co.uk has seen - does provide examples of good quality mental health inpatient care.

But it largely puts the blame for its "alarming" results on insufficient staffing levels, a lack of confidence in patients to report incidents to staff, and a tolerance of harassment and assault which would be unacceptable on any other hospital ward.

The charity also calls for all front-line inpatient staff to be trained to respond effectively to patients who express concerns about their well being.

The report also appears to be in contrast to a Healthcare Commission survey's findings last month. It found 79% of service users rated mental health services as excellent, very good or good.

The commission's results prompted the national director of mental health, Professor Louis Appleby, to denounce charities, professional bodies and the media for their "constant denigration" of mental health services.

However, MIND's chief executive Richard Brook told psychminded.co.uk : "Yes, there are very good services. But there are also very poor services. It's a patchy service and when it's bad it's frightening for service users.

"We are hearing that people find some wards dangerous. I think, to be fair, staff feel the same as well. We often hear that of one or two members of staff covering a ward of twenty or thirty people. It is scandalous. A psychiatric ward is where people go to be safe."

Also commenting on the commission's report, Adrian Thomas of MIND said: "There's nothing specific in the Healthcare Commission report about ward environment, ward conditions or the experience of staying in hospital.

"Also questions relating to health care professionals are broken down into psychiatrists, CPNs and other healthcare professionals (social worker, OT, psychologist or other) - nothing explicitly stated with regards to psychiatric (ie inpatient) nurses.

"It seems very weighted towards the outpatient experience - perhaps understandable as 8 out of 10 patients surveyed were outpatients - but not really a justification for Louis Appleby's belief that everything is smelling of roses with regards inpatients."

The Ward Watch report also claims ministers have failed to keep their pledge to end mixed sex psychiatric wards.

Twenty three per cent of the survey's respondents said they have been sleeping in single sex wards. This is 14 months after the health minister Rosie Winterton reported to the House of Commons that 99 per cent of NHS trusts provided single sex wards for psychiatric inpatients. The Department of Health document, Safety Privacy and Dignity in Mental Health Units, specified that it had the "clear objective" of the end to mixed sex accommodation in 95% of health authority areas by 2002.

The report also states that 31 per cent of patients who took part in its survey did not have access to single sex bathroom facilities. In 2000 this was designated a "miniumim requirement" by the Department of Health in its document, Safety Privacy and Dignity in Mental Health Units.

Mental health professionals and campaigners recognise that single sex wards are vital in the creation of safe, therapeutic psychiatric ward environments. Many inpatients exhibit distressing behaviour which can be threatening to other patients, particularly women and those whose mental health problem is linked to sexual or physical abuse.

But Prof Louis Appleby, believes that there have been genuine improvements. He told societyguardian.co.uk: "There are signs that the pressure on the wards is easing, and we're seeing that, in various units where the bed occupancy rates are coming down."

Among MIND's recommendations is that trusts take a more proactive approach to dealing with safety on mental health wards, and by investing in staff training on dealing with challenging behaviour, and addressing staff shortages.

See:
Aug 20, 2004: Most mental health care professionals treat service users with respect and dignity, according to report by NHS watchdog - media, professional bodies and voluntary sector should, therefore, stop their "constant denigration" of mental health services and staff, says mental health tsar Prof Louis Appleby

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