Mark Brown explores a newly launched research project exploring safety in mental health inpatient settings
Mental health inpatient wards are supposed to be safe places. They’re where we find ourselves when we are at our most vulnerable.
The question of safety and who has responsibility for making these spaces as safe as they should be is often an unspoken question in mental health. This question came into sharp focus last month when patient leader Alison Cameron brought to public attention an incident she witnessed while an inpatient.
Kathryn Berzins, a Research Fellow in the School of Healthcare, and John Baker, Professor of mental health nursing, both at the University of Leeds are beginning a project to bring questions of safety into sharper focus which will involve collecting experiences of receiving, providing and caring for someone receiving inpatient care for their mental health.
Says Berzins: “Safety in mental health care has not really been thought about in much depth. There has been a lot of focus on suicide and homicide, and other things you would expect to see in hospitals like infection control and falls prevention. We certainly don’t know about service user and carer’s priorities for safe mental health care and treatment, or their suggestions which could make services safer.”
Baker says that “safety incidents are recorded in very physical terms, such as ‘did somebody need medical attention as a result of a fall?’” He is keen that we also begin to think about the psychological consequences of being a patient on an inpatient ward: “We think psychological consequences are just as important. My whole career I have believed that service user and carers should have more involvement in the care that is provided. I have seen and heard about countless examples when care or treatment has either exposed people to risk or just not been safe. Often at these times services users and carers are excluded from discussions about how things could have been changed or improved.”
To begin this process, Berzins and Baker are carrying out an initial survey with people with mental health difficulties, those who care for people with mental health difficulties and mental health staff looking at attitudes to safety. Says Berzins: “This is the start of our project looking at safety in mental health services, it is very important to us that service users and careers are involved from the start, tell us what their priorities are and help keep us on track throughout the study. We’re also hoping that collecting people’s opinions will allow us to develop future research studies looking at specific areas of concern in more detail.”
The pair are currently developing a range of studies investigating safety issues for both service users and professionals in mental health care, in both hospital and community settings. Berzins is particularly interested in the use of restrictive practices, service user and carers experiences of care and treatment (particularly that carried out under the Mental Health Act), and criminal behaviour in hospital settings.
Both feel this work is vital in the current climate: “The NHS and Mental Health services in particular seem to be under increasing strain,” says Baker. Enabling services to provide safe and effective care is undoubtedly important. Finding out about the most important priorities now is key to developing this work in the future. Initially we want people to complete the survey, and if they are interested they can become more involved afterwards by taking part in a telephone interview or even becoming a member of a steering group.”
To take the survey here: https://leeds.onlinesurveys.ac.uk/safety-issues-in-mental-health-care-services
Mark Brown is development director of Social Spider CIC. He is @markoneinfour on twitter.