Stress Takes Its Toll On Mental Health Nurses

A mental health service commended for its quality care is now deteriorating, says a senior member of medical staff at The West Cumberland Hospital. And the stress on nursing staff is so apparent that it could lead to many leaving the service, she warns. The senior staff member echoes concerns highlighted in The Whitehaven News, recently, by Distington GP Dr Jeff Rudman. He said that staff working for the mental health service are too frightened to speak out, but that the service was in danger of collapse. This has resulted in other local people speaking out.

This latest member of staff, who does not want to be named, is very concerned about the reduction of mental health services in the area. As well as raising concerns locally, she has also written to Tony Blair and her local MP. She too is concerned about the closure of Windermere Ward.

She said a well-run patient-centred psycho-geriatric service should acknowledge that elderly patients frequently have physical and mental health problems at the same time and that any changes should be evidence-based.

“Whenever I asked for evidence for the reasoning behind the reduction in our service I was told it works in Penrith. In West Cumbria we are rapidly moving away from this ideal situation, where elderly people with mental health problems are visited at home by a community nurse who no longer has back-up of day or in-patient assessment.

“This puts enormous stress on nursing staff and is likely to lead to them leaving the service. It also leads to inappropriate admission of such patients to acute medical wards and such admissions are likely to then lead to institutionalisation of an individual much earlier in their mental illness; surely not what we as a society should be aiming at?”

Other concerns include the combination of Windermere and Yewdale wards – staff feel that this is unsafe as it means having young people who may be violent and drug users in the same place as elderly and frail people.

Futhermore the new Chambers system of working means that local care homes no longer have direct access to consultants, who are now based in Wigton.

“Consultants are no longer involved in ‘routine’ ward, day hospital, care home, or day centre reviews, only seeing patients who have been ‘screened’ by nurses – where is the consultant responsibility and multidisciplinary team work in this system?”

Dr Andrew Thornton, a middle grade doctor at The West Cumberland Hospital, said: “There is widespread concern among staff – including some consultants – that, bit by bit, services are all being transferred to Carlisle. There is also concern that a new hospital in West Cumbria will only be a community hospital not an acute general hospital.”

A spokeswoman for the Trust said an event was held recently which involved informing staff, service users and carers about the progress of the modernisation developments.

About 70 people were involved and heard plans to build a new multi-million pound facility to replace the current combined Yewdale and Windermere wards.

“The Trust is continuing to modernise and develop its services ahead of the multi-million-pound investment in buildings announced last year. Recent developments have enabled increased investments to community mental health services in North Cumbria and changes to the way Consultant Psychiatrists work through the ‘Chambers’ model.

“Investment in West Cumbria has led to the introduction of the Crisis and Home Treatment (CRHT) who provide assessment and home treatment as an alternative to hospital admission for people experiencing a severe mental health crisis, together with the Care Home Education Support Service (CHESS) Outreach team which provides practical support to the local care home market.

“The North Cumbria ‘Chambers’ model was introduced in 2005 to tackle the problem of providing equitable access to a rural population by consultant psychiatrists and help reduce waiting times for people needing to see specialist mental health staff.

“Consultants continue to see patients on a regular basis in a variety of settings to ensure that they have a personal knowledge of individuals.

“The model benefits local GPs by providing them with 24-hour telephone support, seven days a week, and access will be further improved by the expected appointment of four additional consultant psychiatrists over the coming months. As with all new developments, the Trust will be undertaking a full evaluation of the scheme.”