Most mental health patients do not feel safe, survey reveals
The first ever official survey of NHS mental health inpatients has revealed high levels of dissatisfaction with services, with only a minority of respondents saying they “always felt safe” on the wards.
The groundbreaking findings, published today, show only a third of patients felt fully involved in their care and treatment. Many were denied access to counselling or so-called “talking therapies”, while the side-effects of medicines were inadequately explained.
Based on interviews with 7,500 people recently discharged from 64 NHS trusts across England, the survey was carried out by the Care Quality Commission (CQC), the body responsible for regulating health and social care. The questionnaire was given to those who had left hospital in the previous six months after a stay of at least 48 hours on an acute ward or psychiatric intensive care unit. Though 30% of patients reported feeling unfairly treated – on the grounds of age, race, sex, disability or for “another reason” – 70% made no complaint about unfairness.
The commission promised it would act to ensure that NHS trusts improved services. “It is not acceptable for people to feel unsafe in hospital, or for them not to be to given basic information about their care and treatment,” said Lady Young, chairwoman of the commission.
“All trusts must provide a therapeutic environment in which patients can feel safe and recover. [The] environment must include adequate access to activities and talking therapies. There is considerable room for improvement … we will be writing to all the trusts covered by the survey and continue to push for improvement through our assessment and registration systems.”
The survey exposed two areas previously of concern among mental health professionals: the failure to focus on patients’ needs, and the dangers posed to vulnerable individuals by potentially violent fellow patients. Earlier this month an inquiry reported on the case of triple killer Peter Bryan, who battered to death a psychiatric patient in Broadmoor secure hospital.
Questioned about safety, just 45% of respondents said they always felt safe on the ward while 39% said they sometimes felt safe and 16% said they did not feel safe at all.
Another complaint highlighted was the lack of activities available to patients, with 35% saying there was too little to do on weekdays and even more, 54%, reporting the same for weekends and evenings.
On access to talking therapies, such as counselling, cognitive behavioural therapy and anxiety management, 52% said they wanted such treatment, but only 29% of respondents had received it.
Among the more positive responses were 85% saying they were made to feel welcome when admitted to hospital. Only 8% said they ever had to share a sleeping area with patients of the opposite sex during their stay in hospital. Nearly three-quarters of patients rated their care as “good”, “very good” or “excellent”.
But as many as 27% said they did not have their rights explained in a way they understood when they were sectioned under the Mental Health Act. Almost half (48%) said the potential side-effects of prescribed medicines were not explained to their satisfaction. Only 44% of those with physical health problems felt those were dealt with fully and 22% said that not enough care was taken of their physical complaints.
More than two-thirds of patients said psychiatrists treated them with respect and dignity, but only 41% said they were given enough time to discuss their condition with nurses.
Paul Corry, of the mental health charity Rethink, said: “These are shocking figures. If they were applied to people receiving treatment for diabetes, cancer or heart disease there would be a national outcry.” Phil Hope, the care services minister, said: “It’s good news that 73% of people described their care overall as good, very good or excellent. It’s also important to remember that nearly half of the people … had been detained under the Mental Health Act and had severe mental health problems, which may have affected how safe they felt. It is vital they get the care, support and treatment they need.”