Safety within mental health wards

In recent months I have seen an increasing number of incidents of neglect being highlighted in the media where trusts have been successfully sued over their duty of care. For instance, Melissa Martin-Hughes http://www.guardian.co.uk/society/2012/feb/27/teenager-hanged-failure-mental-health

Or Carol Savage http://www.independent.co.uk/life-style/health-and-families/health-news/suicide-claim-win-against-nhs-sets-rights-precedent-1960387.html

And the repeated reports about the levels of assault/harassment/abuse on mental health wards. http://www.spn.org.uk/index.php?id=1016

http://news.bbc.co.uk/1/hi/health/5056048.stm

And most recently on Sunday Politics London (25/3/2012) http://www.bbc.co.uk/iplayer/episode/b01dmtgh/Sunday_Politics_London_25_03_2012/ (Reporting starts at 37:15).

“An allegation of rape or sexual assault involving patients using mental health services in the capitol is made every 3 days those involved are victims and perpetrators”

“In 9 out of 10 of London’s mental health trusts. In the last four years there have been 523 allegations of rape, sexual assault or harassment involving mental patients. The trusts say that they know at least 134 of these allegations definitely happened but were only able to tell us of 2 cases that resulted in prosecution.”

Figures that would make anyone cry.

I welcome the governments’ reform in this area however without information it has never been clear how much of a problem exists and sadly I feel that this is the real problem, the not knowing, for how can you combat an unseen problem? How can you look at the variables and find strategies to reduce the chances of it happening in the future when you have no idea how it has happened in the past nor how frequently?

That information is being gathered is certain however this is not being published for the public to view and I would urge people to consider how a more transparent approach to the problem would aid in gaining peoples trust.

If you want people to see you are concerned about what is happening then why not show them what you are doing? Publish the results of your findings instead of hiding them from view.

It seems to me that much like child abuse the abuse of the mentally ill is often unseen/ unbelieved and therefore unpunished. The difference here is that unlike children the mental ill population have not been targeted for understanding. The idea of a vulnerable adult and what that may mean specifically is alien to most and not thought about. In fact the taboo nature of mental ill health has meant most have avoided any contemplation of the subject regardless of their own contact with it. It seems that many cannot believe that someone who may harm them self could be telling you a crime has been committed and it be true.

It has been left to a small proportion the populous to consider and implement appropriate policing/monitoring processes for the service both for staff and for the users and as such it is lacking the thoroughness that many of the other services have.

It does not surprise me that the prosecution rate is so low. The general disbelief of the mentally ill due to the problems they may have increase the chances of their allegations being unprosecutable.

The new changes in attitude and policy mentioned in Sunday Politics London (police liaison in wards, open investigation etc.) are moving in the right direction however their ability to reach out to the people they need to is limited at present purely because of past precedent. The people have so many reasons to distrust authority in any form and therefore any initiative will take effect slowly.

From my perspective I find it difficult to conceive how such abuse is occurring on a ward particularly the patient on patient abuse. It seems particularly naive of the staff and begs the question of whether the levels of staffing/ supervision of patients deemed appropriated is actually appropriate? No one wants to live in a prison and certainly not the mentally ill however if such abuse is happening under the noses of the staff by patients then it seems logical to suggest that actually the care given is not appropriate and whether it is being reported or not is somewhat irrelevant to curing the problem of it occurring.

For instance this article Sexual Harrassment on Mental Health Wards http://www.spn.org.uk/index.php?id=1016 states:

Policy for the last six years has been for women-only wards, which are expected to maintain women's safety in relation to men service users, visitors and intruders: the implementation of this, however, has been completely inadequate despite continual assertations from the Government that 99% of all mental health wards are single sex. It remains unclear how many wards have women-only staff, a matter of serious concern given that eleven of the reported rapes were by male staff, and the high levels of abuse and violence from men experienced by women in their lives which have contributed to them being in hospital in the first place.

The article states that of the 120 sexual assaults there were 19 rapes which means that 58% of the rapes were committed by staff members.

And whether you buy into the belief that making sure that by no man entering the female ward you would solve the problem I would suggest that a long look at the selection, supervision and appraisal system for staffing these wards is in order because it is not just rape by staff that is the problem, it is abuse in general and if they feel they can get away with rape then what else is occurring?

At present it seems far too easy for crimes to occur under the current system and a great deal more care needs to be taken to ensure these crimes stop and those that have occurred are punished. I realise that allegations do not necessarily mean crimes committed and again I would urge people for more transparency with the figures, findings and prosecutions. Protect the people identities but release the figures.