Unsafe and dilapidated mental health buildings ‘a disaster waiting to happen’ – Royal College warn

Unsafe mental health buildings are a “disaster waiting to happen”, the Royal College of Psychiatrists has said.

Dilapidated buildings and years of under-investment have been exposed by Covid-19, with old and overcrowded mental health wards increasing the risk of infection, it said.

A report from the college said psychiatrists had no space for putting on personal protective equipment (PPE) and no hands-free handwashing.

They also reported “no space for social distancing and no space for patients to isolate”.

One psychiatrist said: “Covid-19 spread rapidly on my ward in March. Six patients and multiple staff tested positive. Most patients were in bays. Only one side room has an en-suite.”

Another said: “We have four bedded dormitories so patients can’t be isolated or shielded. We only have three single rooms.”

A third said: “Lack of single rooms has led to spread of virus between patients.”

A poll of 383 psychiatrists in England for the college found around a third felt the quality of mental health buildings had compromised care for patients during the pandemic.

Some 38% of 305 psychiatrists surveyed said mental health buildings were unsuitable for safely separating patients with suspected or confirmed Covid-19.

Dr Adrian James (pictured), president of the Royal College of Psychiatrists, said: “Covid-19 brutally exposed the years of neglect that left some mental health services struggling to control infection.

“The Prime Minister’s recent announcement of investment is timely, but we need an urgent and immediate injection of cash to prepare buildings for the next Covid-19 wave – followed by substantial long-term investment.

“This devastating pandemic presents us with an opportunity to learn and invest to make our mental health facilities the best in the world.”

The college is calling for a ring-fenced extra investment of £3.3 billion to significantly improve facilities at the next Government spending review.

The organisation said mental health providers often receive a disproportionately lower amount of capital funding than other bodies, meaning there is less cash for building upkeep.

In 2018/19 almost £13 million of outstanding high-risk repairs in mental health and learning disability sites were reported – an increase of over 150% on two years earlier, it said.

A senior source at a hospital trust said: “Old and overcrowded buildings are simply not fit for infection control and the danger of cross-infection is very high.

“Our patients are seriously mentally ill people who need to be treated in hospital, yet we were constantly having to make the judgment: Where would it be safer for them to be? On a ward struggling to manage Covid cross-infection or back at home where their mental state might get worse?

“Time and time again mental health has been completely left out of the hospital rebuilding programme.

“We can’t keep treating people with mental illness as second-class citizens. If Government is serious about addressing the needs of those with mental health problems, we need investment for our estates. We simply can’t go on for much longer without it.”

The college wants £376 million (25%) of the Prime Minister’s recently announced £1.5 billion of NHS capital funding for 2020/21 to be ring-fenced for mental health NHS trusts.

It also wants a £1 billion building and redevelopment programme to enable 12 major mental health projects to be completed by 2030.

Some £950 million would help to eliminate dormitory wards and same-sex accommodation, create en-suite facilities for all existing single rooms and make units more suitable for people with disabilities, it said.

A Department of Health and Social Care spokesman said: “There are strict infection control measures in place across the NHS to protect patients and staff and prevent the spread of coronavirus, including hand hygiene guidelines, PPE and social distancing where possible.”

“We want all patients and staff to benefit from safe, world-class facilities and have committed £1.5bn this year for hospital maintenance. This includes replacing outdated mental health dormitories, which will ensure vulnerable patients get the care and treatment they need in an appropriate setting.”

Copyright (c) PA Media Ltd. 2020, All Rights Reserved. Picture (c) The Royal College of Psychiatrists.