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More than
40 psychiatric patients per year die of "unexplained”
causes
December
18, 2006
by Angela Hussain
More
than 40 psychiatric patients per year are dieing of "unexplained”
causes while on mental health in-patient wards.
Heart
failure from antipsychotic drugs, the use of physical restraint,
“physiological arousal” from a patient’s mental
illness, and underlying heart disease are likely to the cause of
such deaths, states a new report.
The
report, commissioned by the National Patient Safety Agency, was
carried out by the government's national inquiry into suicide and
homicide by people with mental illness.
There
were 235 "sudden unexplained deaths" on mental health
in-patient units in England and Wales between 1999 and 2004. This
is 41 cases per year.
The
report's authors recommend a “cautious” approach to
prescribing of antipsychotic drugs, better monitoring of patients
with heart and breathing problems and that physical restraint be
used as a last resort and according to official standards.
The report, entitled Avoidable Deaths,
also stated around 50 homicides are committed each year in England
and Wales by mental health patients. This is 9% of total homicides.
But the number of homicides by the
mentally ill is not increasing, and the risk of “random”
killings by such people has not risen in the last 30 years, emphasised
the authors.
Of the total 600 average homicides
per year in England and Wales, the inquiry found 30 (5%) were committed
by people diagnosed with schizophrenia.
"Community
care has not increased the risk to the general public,” stated
the report.
But
the report, published this month, emphasised that many psychiatric
patient suicides - around 1,300 per year - and homicides by people
diagnosed with a mental illness were preventable.
Researchers found that in the week prior to suicide, 49% patients
were seen by mental health services. But staff judged only 14% to
be at risk of suicide.
And
in the week prior to homicide 29% patients were seen by services.
But staff judged only 9% of these to be of moderate or high risk
of violence.
Prof Louis Appleby, the national director of mental health, said
staff - such as psychiatrists and nurses - are wrong to believe
many patient deaths or homicides are inevitable.
He
said: “It is time to change the widespread view that individual
deaths are inevitable – such a view is bound to discourage
staff from taking steps to improve safety.”
Prof
Appleby was also quoted in one newspaper as saying that mental health
professionals are becoming “desensitised” to the violence
or suicide risk of some patients.
The report was published as the government tries to extend compulsory
powers of detention and treatment over some psychiatric patients.
But campaigners opposing planned new law say the Avoidable Deaths
report revealed no need for further compulsion powers.
Andy
Bell, chair of the Mental Health Alliance, a coalition of 78 mental
health, carer and law organisations, said: "There is no lack
of compulsion in current legislation. Mental health law is one of
the most powerful legal tools there is - people can already be detained,
and treated against their will if necessary, if doctors suspect
there is any danger.
"The
myth is that the move to community-based care is behind these incidents,
but that is absolutely not the case.
"The number of homicides by people with mental health problems
has not changed since the 1950s and the days of asylums, even as
the overall murder rate has increased." significantly.”
Read for
youself:
Avoidable Deaths report
(pdf)
See
also:
Mental
health comment
Dec 12: CTOs do not
work...and that's according to the evidence base
- Community
treatment orders will help protect the public from mentally people
who kill, says the government. But what of the evidence for such
a claim?
Feature:
Dec 11, 2006: Deaths for no reason? What
can be done to prevent psychiatric patient deaths during restraint?
Geoffrey Hodgkins (left) was one such victim
Dec 1, 2006:
Government presses ahead to force some psychiatric patients to take
medication in community - plans in new mental health bill
Nov 22, 2006: Professionals
gave psychiatric patient murderer “too much liberty"
- states report into random killing by patient of Springfield unit
in south London.
Feature
Nov 9, 2006: Are homicides
by people with mental health problems preventable? Tony Maden
believes recommendations he submitted to the government could result
in a cut in homicide rate by psychiatric patients of 10 per cent
in five years. Is he realistic?
Video report
Nov 9, 2006: "Staff
are willing - but we lack funds" - three delegates at the
Mental Health Today conference on their experience of inpatient
psychiatric wards.
Oct 30, 2006: Patient who died after
being restrained not threatening anyone, report reveals - staff
also made no efforts to engage with schizophrenia patient before
restraint used
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