Monday, 25 June 2012

Failings of the NHS with Psychiatric care

I am very sad to report that one of my closest friends is in a psychiatric hospital. This isn't something I would normally blurt out to the world - after all, its not exactly good news. However - following the shocking snippets I have received describing the poor level of care she has received since her arrival there on Monday - I have no choice but to share this with you in order to increase awareness of what goes on behind closed doors in these institutions.

My friend L is in a hospital on one of the psychiatric wards having arrived straight there from another hospital - the first hospital she was in was a private one - she had been there for a month on this occasion but this was a very expensive option and an alternative had to be found - hence why she moved on Monday to an NHS hospital. L's parents visited the new hospital a couple of days before her admission to see the ward they were told she would be on  - this was so they could mentally prepare for the change and perhaps meet the new staff who would look after her, and enable them to reassure their daughter that the new hospital would be ok - there was no way L was going to be able to see this new place for herself before the day she arrived.

This first visit was apparently excellent and not as daunting as had been expected, but of course not as smart as ****** (First Place). So first impressions are quite good - slightly better than originally thought and things are looking up.

L arrived at the new hospital on Monday - no doubt feeling wobbly (understandably) having had to say goodbye to the staff and other patients in the private hospital who had supported her in such a brilliant way and helped her make such amazing progress. But this was an important and necessary change that might speed up her recovery - everyone had hope that something at this new place might help L get better. How wrong could we all be... She was not put on the ward that had originally been arranged - it was much shabbier than anticipated compared with the one her parents had been to see two days previously. It was soon felt that the wrong decision had been made getting her transferred and it was also felt that the psychiatrist was a hard woman who clearly didn't agree with the medication L is currently on - which had been originally prescribed by another top psychiatrist. L's parents were told they only have one chance in a week to try and call the new doctor for an update on her progress.

The ward she is on turns out to be a secure unit for people who have been sectioned. This was not where L was meant to be - but the bed reserved for her in another ward had been taken by someone else. She soon begins to feel even more terrified and anxious than she was in the first place. Hang on - she's meant to be learning how to manage this issue - not have it exacerbated. Surely the idea is to not be made to feel worse - she is here to try and get better.

It is clear the other patients are in a terribly bad way (and for them I am desperately sorry and also angry that they too have also got to get better in such a ghastly environment) - most are sectioned and therefore can not leave and are forced to take certain medications and follow various rules and are monitored constantly (or are they?). They shout, scream, get angry, try to run away.... one man throws a book at L, another lashes out. She can not stand with her back to anyone in case they try and hurt her when she isn't looking. She also has learnt not to stand in a corner in case she becomes trapped. Another person threatens her with a snooker cue and they also shout that they will rape her. The patients use the shower to go to the loo - so nobody including L can use it to wash.

What can she do? There is no consistent therapy or support on offer on a regular basis to keep her and other patients occupied - not on this secure ward anyway - maybe there is on the other ward she is meant to be in. There are the occasional groups or activities organised but these are interrupted, cancelled or rearranged at the last minute. It is understandable that there is very little therapy on this ward - many of the patients are too unwell to be able to engage in it but alternatives should be found which might help them. L tries to sleep as much as possible as this passes the time but its impossible with so much noise and shouting going on around. There seems to be no privacy. I hear you ask: Why can't she just leave? Because they will just section her as she isn't in a good enough place to go home.

It baffles me how ANYONE can get better in this type of environment. The staff are rude and there aren't enough of them to cope with the patients needs. There should be a cleaner or someone assigned to clearing up the excrement that has been smeared on the walls IMMEDIATELY. There should be someone there to show the patients and help them use the shower in the correct way - for their own personal hygiene as well as everyone else's.

The food is inedible. Everything is served with cheese so that the patients don't lose weight while they are in hospital. Hardly anything is fresh. I have already written a widely read post about my thoughts on Nutrition and its connection with mental health - read it here.

L can at least occasionally get outside for some "fresh air" but there is a barbed wire fence surrounding the building that is so high is must nearly touch the clouds in the sky. This is the only place she can get a small amount of signal on her mobile phone to call home - communication with the outside world is almost impossible. I tried to call L last night - as there is no signal I couldn't get through on her mobile so I tried various landline numbers and eventually got put through to her - but was warned by an abrupt and rude member of staff to be as quick as I can. I appreciate the nurse's need for me to be brief on the phone but there is absolutely NO excuse to ask me in a rude and aggressive tone. The word please in his sentence would have been appreciated.

The staff not only seem rude - they also don't appear to be able to dispense medication properly. There is also no excuse for nurses and health care professionals working in a hospital's psychiatric ward to be incompetent at providing the patients with the medicines they need to keep them alive and help them get better. It is all total non-care as far as I am concerned. I appreciate that it might be difficult under time pressure to dispense medication to lots of different people - some of whom are reluctant to take it - but to start dispensing the wrong thing and then to look at the patient (who is actually very intelligent and knows perfectly well what her tablets should look like) as though they haven't got a clue is just unacceptable and totally abominable.

I do appreciate that psychiatrists who work for the NHS in big hospitals are also under enormous pressure because they have many, many patients who are all desperately unwell - and it is primarily their job to over see and ensure the sufferers are given the right treatment. It is inevitable that NHS hospitals like this one mentioned above are not going to be as good as the private one L was in prior to this week - but private or not - they should all meet a certain level of care and criteria - this one certainly does not.

I ALSO realise that the other patients are very ill - very ill indeed. Most of them are not in control of their own behaviour. The man who threw a book at L which hit her may not have even have realised he did it. It is not these patients faults that they are unwell - they did not choose it. In the same way that you don't choose cancer or autism. But the NHS and other health care professionals should do all they can to help these people and protect other patients who are at risk of these erratic behaviours. It is the staff's responsibility to create a safe, caring and calm environment to help improve things for the patients - this is not happening for L as far as I am concerned.

L is due to go to the Maudsley Hospital in London but why should she have to put up with poor care like this in the mean time until a bed becomes available there? Why should she have to pretend to be a smoker in order that she can go outside to get phone signal and talk to her parents on the phone in order to get a bit of privacy? What part of keeping these patients in darkened rooms with no natural light or fresh air is healthy and will help them improve? Why should she have to wait for a friend or her parents to come and pick her up and take her out in order to have a proper CLEAN shower? Why should L and her parents have to pay for her taxi to and from the hospital to see her therapist (there clearly aren't any where she is now - and seeing the one she already knew is a small fraction of continuity from the care she had before)? Why can't the hospital pay? The NHS have been spared a lot of money for treating L until now - the least they could do is pay for her taxi so she can see a therapist who can help her.

L is now (naturally) anxious about what the Maudsley will be like based on her experience of this NHS hospital - and she is reluctant to move there when the bed becomes available because she wonders if it will be as bad as where she is now. It is renown for its world class care - and by the sounds of things, anything is better than this week's stay.

This is real. This is happening right now in far more hospitals than the one L is in. We don't often know what goes on behind closed doors. Too many people are not being supported properly and given the right treatment. Why should the best treatment cost the earth? Why can't everyone be entitled to receive treatment at the high standard of many private hospitals? 

I want to start a campaign. I want this blog post to be circulated to as many people as possible - particularly within the health care field - in order to raise awareness and start a revolution in improving psychiatric care. 1 in 4 people have a mental illness and are therefore at serious risk of needing treatment like what I have already mentioned.


  1. I am with you, Miranda! It. Is. Not. Right. Whatever your campaign...I join you. It is not right to treat humans in need of proper care, loving, compassionate, intelligent, sound care. Everyone deserves this. I am so sorry for L and her family and for all the others in that ward.

    1. Thank you so much for your message Sarah - it really is ghastly. Hope this doesn't have to happen to other people but sadly it does. Really want to kick start a campaign...

  2. This is disturbing to read, I have worked as a mental health nurse for over 20 years in the NHS and whilst all of my time has been spent in community services my contact with in-patient units has not been like the one detailed above. All Trusts have clear governance structures which service users and relatives/carers can access and affect change in relation to environment/medication errors/serious incidents/draconian 'rules' etc. Failing that I would urge you to contact the Care Quality Commission who inspect all care facilities, NHS, private and third sector in the UK
    I appreciate navigating your way around complaints can be tricky, happy to help if I can.

    1. Thank you TwitKingaby for your very interesting and helpful response to this post. I wonder whether you could maybe circulate it to as many people as possible via Facebook/Twitter/colleagues etc in order to spread the word? Navigating the way around complaints can be a nightmare as you say as its hard to get the message through to the right people - I will let you know how we get on. The most recent news is that L is being discharged today which seems quite sudden - they have obviously decided some else needs the bed so they are kicking her out but they haven't taken into account how she is feeling and whether she will cope at home.... her parents are obviously very relieved that she will be out of that place.

  3. yet another excellent post/blog Miranda and circulating now! Appalling and so prevalent not only in the UK but globally. Your efforts to raise awareness is so important and I am grateful to you for all you do to help. Off to circulate, circulate, circulate x