Most psychiatric units have failed to fully implement the ban on smoking and many have reported a rise in 'secret smoking' by patients, the Mental Health Foundation said today.
A survey of units found 85% had not implemented the ban in full or at all, and revealed widespread practical problems in enforcing the prohibition, which came into force on 1 July, 2008.
Many units lacked a safe outdoor space for patients to smoke in and even where this existed, the need to escort patients outside to smoke was a considerable drain on resources.
Staff feel like police
Staff felt uncomfortable about enforcing the ban, the survey found, with some reporting feeling more like police than nurses. In some cases, staff turned a blind eye to smoking, particularly when a patient was very unwell.
The rise in secret smoking also prompted concerns about possible fire risks from the disposal of cigarette butts.
The report found that in units where the ban had been successfully implemented, there had been widespread consultation with staff and patients beforehand and there was sufficient provision of support for patients to stop smoking and alternative activities.
Formal review urged
It called on the National Mental Health Development Unit - the Department of Health agency that leads on mental health in England - to disseminate good practice from successful units, and urged the DH to carry out a formal review of the ban's effectiveness.
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