Mental health cuts leaving workforce exposed to routine violence and aggression, survey

Reduced funding to mental health services across the UK is leaving staff vulnerable to violence and aggression from patients, and means they cannot provide the level of care needed, says UNISON.

The report, Struggling to Cope, paints a bleak picture of the country’s mental health services – for both staff and users. It is based on a survey of over 1,000 mental health employees across the UK, who work in a range of roles – with children and adults in hospitals, in secure units and out in the community.

More than two in five (42%) said they had been on the receiving end of violent attacks in the last year. Over a third (36%) said they had witnessed violent incidents involving patients attacking their colleagues. Comments from some staff suggest that “violent or aggressive incidents happen on a daily basis”, and that they “go with the job”.

One worker described being “repeatedly punched to the floor”, while others spoke of “attempted strangulation”, or being head-butted, spat on, kicked and bitten.

While the majority (86%) felt they had the knowledge and training to carry out their work safely, more than a third (36%) said they had seen an increase in violent incidents in the past year.

Mental health workers blamed staff shortages (87%) and the overuse of agency staff (49%) as the main reasons behind the rise in violent attacks.

More than two-thirds (68%) felt that service users were increasingly reaching crisis point before accessing services because of a lack of staff, funding and beds. Worryingly, cuts also mean that a third of staff (33%) are now having to work alone (when they did not previously), making them more at risk of being abused, says UNISON.

Six in ten (60%) of staff responding felt they were unable to support the people that they care for properly, and almost three-quarters (74%) reported feeling stressed because of their work.

The survey also reveals that a third of the mental health staff questioned (32%) did not report violent incidents when they happened. Of those that did, 31% did not feel supported by their managers afterwards.

UNISON says it’s hardly surprising that more than a third (34%) are thinking about leaving their jobs in mental health, and 14% are actively planning on doing so.

The main reasons cited by staff were the fact that they’d not had a decent pay rise for seven years (44%), the impact of their work on their own mental health and well-being (38%), and the poor state of the mental health sector (37%).

UNISON head of health Sara Gorton said: “These findings highlight a range of deep-rooted issues in mental health services that need to be addressed urgently.

“The lack of prevention and absence of early intervention services mean that by the time many people access help, they are already very ill and at crisis point.

“Severe staff shortages mean there are fewer mental health employees to deal with a rising number of users with complex needs. As a result, many staff are having to work alone, making violent attacks more likely. It’s no wonder so many are planning on leaving for less stressful, safer work elsewhere.”

Last year, NHS England’s Five Year Forward View on mental health said there was a need for a “strengthened approach to prevention and early intervention”, and “good practice in the management of mental health in the workplace” to support staff.

UNISON is calling on the government to ensure staff and patients are kept safe by properly funding mental health services, and that staffing levels are properly reviewed with the introduction of safe minimum patient to staff ratios.

The survey was carried out in September 2017 and is available here.