Mental Welfare Commission visits to hospital wards

Dementia Care
April 19, 2017

The Mental Welfare Commission for Scotland has a semi-independent role of scrutiny over mental health services in Scotland. It is accountable to Government and carries out its statutory duties by visiting people, monitoring the implementation of certain legislation, carrying out investigations and reporting, providing advice and information and influencing policy and services.

Recent report on hospital admission wards

On the heels of the launch by the government of a new mental health strategy this month, the Commission has released a report on return visits it carried out to all adult mental health admission wards towards the end of last year. 47 wards were visited, and Commission staff spoke with 323 people.

The findings

The findings were mixed. The Commission found significant improvements, in recovery-based care, and in care planning. Also, peer support workers were more widely used. They also found reduced stigma and prejudice towards people with mental health problems. The environment had improved: most people felt respected and were satisfied with their experiences in the ward.

However, concerns included:

  • Only 4 of the 47 wards were single sex
  • Lengthy admissions and delayed discharges
  • 16% of patients felt unsafe, rising to 25% for women on mixed wards
  • Many people stated they had no access to exercise, although wards reported that there was access to gyms
  • Low staffing levels were reported as contributing to some of these problems
  • Most wards did not have regular input from a psychologist

This should make for chastening reading. One woman spoke of having on one occasion to jam her door at night in order to be safe. Others spoke of excess noise and occasional disturbing behaviour at night.

The Government has expressed its concerns, and has undertaken to address the issues emerging from the report.

The National mental health strategy – implications

There is a commitment to extra funding for the national mental health strategy over the next ten years. Some of this funding may address the understaffing concerns which were revealed by the MWC. However, it is not clear how much of this funding will reach the understaffed hospital wards, given the wider, preventive scope of the strategy, admirable though this is.

Another possibility is that this report and its findings will change the strategy, to ensure that good practice is more consistently applied. As it stands the report shows that in some wards what was seen was how not to provide mental health support. The Government wants parity of esteem for mental and physical health services: to achieve this, clearly much work remains to be done in several areas.

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Tony Clarke

Scottish Care Inspectorate Specialist

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