Thursday, June 24, 2010

Concerns raised over psychiatric unit admissions

Ok things still well here.

Anyway, came across this article called 'Concerns raised over psychiatric unit admissions' yesterday which got me thinking about my time in the Psychiatric wards, - the four admissions last year. and I guess the near miss of last week.

The article, which is worth a look in my opinion talks about the inappropriate and detrimental admissions of patients to Scotland's IPCU (Psychiatric intensive care units)

One of the major complaints was that

'As well as a shortage of "talking therapies", patients also complained about a lack of access to fresh air and outdoor and activities.'

The article seems to justify this complaint by suggesting the nature of the 'intensive' unit required a peaceful approach. Having spent a good few months as a guest of my Trusts general admissions ward (a Trust which gets Very good ratings) I can mirror such complints. In one admission I spent 6.5 weeks on the ward. There was no talking therapies. In fact the only talking was amongst patients, as nurses were seemingly too busy in 'their office' or doing 1-1 obs to talk with patients. There was no outdoor activities. I was not on a section but it was over a week before I saw any sky, escorted trips to the garden were reserved for smokers only, and the unsmoking minority were forgot about.

One comment in the article was that 'restraint was sometimes forced on patients who did not need it'.
Sad and again in my experience true, for the psychiatric ward I was on. I myself have been subject to IM Lorazepam injections and serious restraint with severe bruising. My crime on one occasion- washing-up too loudly. I kid you not. And being wrestled to the ground by two big HCAs whilst trying to clean their dirty plastic cups is not to be forgot. I also saw others subject to forced sedation for being 'too rowdy', sigh..

However the statment which sticks out for me most is

'A number of service users compared IPCUs to their experience of prison and felt that prison was a less restrictive environment.'

I have never been to IPCU . I have never been to prison. But I have heard patients on the wards say very similar things. In prison you usually have a cell either to yourself or shared. This is locked and so you are pretty safe at least for the hours you are in there. The main thing being at night whilst asleep when you are most vulnerable. I was on a mixed sex ward, and in a female dorm with three beds. However next to male dorm. One of tha males had told me, quite convincingly that he would wait until nightime and come and find me ' to have sex with me'. The doors were not locked. Nightime staff were few and far between. I did not feel safe. As far as I'm aware all prisons are single sex- or have single sex wings. There is undoubtedly a better range of activities in prison. usually a gym etc. And I am reliably informed by Trust staff that prisoners meal budget is significantly higher per head than that of psychiatric inpatients. (50p per head/day for all three meals being the hospital quota)

I realise it's nothing new, but these articles reinforce that Pychiatric inpatient care is not good enough. People are in need of a thereapeutic, safe and supportive environment at times of acute distress/illness. This in my experience is not provided.

Last week I was extremely suicidal. However, when offered and almost forced with psychiatric admission, I would rather risk my life to be in the community. If death to me is preferable to their supposed 'place of safety' then surely, my Trusts and others should question why is this?. If I think it would have achieved anything or even have kept me safe, I would have packed a bag and happily have popped along to the hospital. I know that in all probability there wiill come a time when I will be back there, and thats enough to keep me awake at night.


intothesystem said...

You pretty much echo my thoughts on this. I was on a standard single-sex acute ward and had the same problems with fresh air, no talking therapies, no therapies of any other kind etc. Inpatient treatment really is a terrible option.

La-reve said...

It is, and is why I would have to be sectioned to ever go there again and even then I wouldn't go down easy.

Anonymous said...

Il semble que vous soyez un expert dans ce domaine, vos remarques sont tres interessantes, merci.

- Daniel

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