Care Quality Commission

Psychiatric wards are “frightening and dangerous”

Acute psychiatric wards are “frightening and dangerous”, according to the  .

In what is the latest in a string of damning reports on the condition of private and NHS psychiatric units over the last few years, commissioners say they are also “tougher, scarier places” than 10 years ago.

This week’s report followed commissioners’ visits to 6,000 detained patients over the last two years.

The commissioners drew parallels of today’s inpatient units with the “evils” of the madhouses listed by a parliamentary enquiry in 1815/6. These included overcrowded wards with too few staff and a mixing of highly-disturbed individuals with those with less problems.

The commission also reported long-running concerns, such as over-reliance on agency nurses, mixed-sex wards, and young people being placed on adult wards, a practice ministers have vowed to end.

The biennial report read: “The busy acute wards that we visit appear to be tougher and scarier places than we saw a decade ago. Something needs to be done.

“It is scandalous that we are forcing vulnerable people onto mental health wards that are frightening and dangerous places. This should not happen at all, but it should be a matter of extreme priority that children are not placed in such situations, and that women’s safety from sexual harassment, abuse and assault is addressed within the mental health service.”

The government promised to end mixed-sex accommodation in general by 2002, but that has not been met. Some consider the partitioning of wards into male and female areas to be acceptable.

Health Minister Lord Darzi said this week the NHS would have to be rebuilt if all wards were to become exclusively single sex.

Ministers have also promised to end the practice of keeping young people on adult mental health wards by the end of this year.

Health minister Ivan Lewis said progress had been made on giving mental health patients single sex accommodation.
But he admitted: “We know there is more to do.”

Paul Farmer, chief executive of the charity Mind, was concerned by the report’s findings.

He said: “Hospitals should be therapeutic places of safety but unfortunately for some people their hospital experience only serves to hinder rather than help their recovery.”

Marjorie Wallace of Sane said: “With reports like these, how can we proceed with implementing the new Mental Health Act if we are unable to ensure that those detained under its powers are treated and protected in humane conditions?”

Mental health professionals themselves are trying to boost standards in psychiatric wards.

The Royal College of Psychiatrists, in partnership with the Royal College of Nursing, the British Psychological Society and the College of Occupational Therapists, has launched a national accreditation scheme for inpatient psychiatric wards.


What Mental Health Act commissioners found in six months before November 2007

* Vulnerable women housed with predatory men – alleging physical / sexual abuse – unwilling to take complaint forward due to fear of what would happen. Had told male member of staff who had laughed it off.

* Female black patient frequently racially abused by male patient. During the past month physically abused. Commissioner highlighted the same issue on previous visit – no adequate response.

* Three new acute wards with 135% bed occupancy – patients sleeping in day rooms – no curtains – mattresses stowed away by day – no space for belongings – staff run off feet.

* A ward where the plaster on the walls had been removed bit by bit by patient. Some rooms looked like they were in the process of being demolished – staff seemed resigned to the
conditions – patients very upset and angry about the living conditions.

* A woman in seclusion who was deprived of sanitary protection whilst menstruating.

* One detained patient said he was very worried about his life and future as he had raped another detained patient and nobody had discussed these issues with him. When brought it up with the manager, they said that it had been ‘dealt with’.

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