Mental health in-patient services are failing due to overcrowding, unsafe environments and a lack of therapy, the Royal College of Psychiatrists has warned.
Key standards for patient care are not being met in areas including one-to-one interaction between patients and staff and patient involvement in care planning.
While recognising that this “costly area” would be earmarked for efficiencies due to current fiscal constraints and the emphasis on providing care in the community, the college said “quality in-patient care is as vital as ever” for those in severe need.
The warnings came in a paper from the college setting out 10 standards that it said in-patient services should be meeting.
Drawing on surveys by the Care Quality Commission and Mental Welfare Commission in Scotland and the college’s own Accreditation for Mental Health Inpatient Mental Health Services (Aims) research, it found:
• Average bed occupancy rates were well above the optimum of 85%, leading to patients becoming more unwell due to long waits for beds and reduced safety on wards. The CQC has found that just one-fifth of acute wards met the 85% standard.
• Though segregated gender accommodation was “essential for vulnerable patients, mainly women”, just 59% of wards had gender-segregated lounges, according to Aims data.
• Safety standards were not being met with less than 45% of patients always feeling safe (CQC).
• Despite the importance of patient involvement in care planning to recovery, 40% of patients did not feel involved in all the decisions about their care (Aims).
• Just half of patients said they had supportive one-to-one meetings with staff for at least 15 minutes each day (Aims), despite the importance of staff contact.
• Patients lacked access to psychological therapies despite guidelines recommending at least one psychological intervention per week for in-patients.
The college also called for wards to have a maximum of 18 beds, good provision of activities, links with the community and culturally-appropriate care.
It called on mental health trusts and health boards to use the standards outlined in the report as a checklist for improving services.
The report is being formally launched next week as part of the college’s international congress.
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