Study uncovers variations in service on UK's psychiatric wards

Mar 21 2006

A groundbreaking study to assess the state of the nation’s acute psychiatric wards has uncovered substantial variations in service provision and delivery.

This is according to preliminary findings of a three year study, funded by the Department of Health and conducted by Staffordshire University, City University in London and Liverpool University.

Research carried out by Professor Peter Nolan and Catherine Painter of Staffordshire University, has found that the size of wards varies greatly from between 11 and 30 beds, with some of the largest wards in the Midlands region.

Professor Nolan, who led the data collection in the Midlands, added: "The average number of qualified staff is 62 per cent which is higher than elsewhere in the country. However we came across wards where there was only one qualified mental health nurse and other places where all the nurses were qualified.

"Although it’s important to realise that unqualified staff can make a considerable contribution to the care and wellbeing of patients, they are obviously limited in what they can do. We expect to be making some recommendations about qualified staff/patient ratios and the need for continued professional development training".

The £300,000 study was prompted by concerns that acute services have long been neglected and under resourced, with priority being given to the development of community services.

"The examination of acute services is long overdue and service users have amassed a wealth of information that can now be drawn on to improve them," said Professor Nolan, who is Professor of Mental Health Nursing at Staffordshire University.

Preliminary findings specific to the Midlands show that:

• patients refuse medication more than elsewhere in the country
• there are more doctors but less occupational therapy and psychology input than elsewhere in the country
• the physical environment of the wards is better
• there is less use of bank and agency staff
• people admitted tend to be older and are less likely to suffer from severe mental illnesses
• people admitted are less likely to be sectioned and less likely to be considered a harm to others.

"The quality of wards, the décor, food, the help people get in the Midlands is quite good in comparison with what others get elsewhere," added Professor Nolan. "However, there is a tendency for people to be admitted because of social problems, e.g. lack of social support, lack of social skills, lack of friends and lack of income"

"Nationally 70 per cent of patients are saying they do find acute care helpful, they do benefit from their experience there, they do get a lot of help and even in places where resources are scarce patients tend to help each other. Approximately half those interviewed stated that they would be sad to leave because the friendship and support they received was far greater than they expected."

"On a less positive note, approximately 50% of patients are unsure as to why they are admitted and too many seem to relapse within a short period following discharge. There is a great pressure on beds, resulting in some patients being discharged too early and often giving rise to poor aftercare."

Professor Nolan concluded that patients, in addition to wanting good treatments, want more information and education about illnesses and treatments and how they can play a bigger part in their own treatment and recovery.

The preliminary findings, from this study were recently presented at Staffordshire University when a large number of delegates met to discuss the findings and their implications. The resulting report, which is currently being written, will be formally presented to the Department of Health this summer and it is expected that it will influence the direction of acute mental health care in the near future.

http://www.staffs.ac.uk