Hospital patients need to be actively supported.

Take a look at NHS Wales’ new report Making Days Count – National Review of Patients Cared for in Secure Mental Health Hospitals  – essential reading for anybody concerned about people with a serious mental illness.

It’s a long report with valuable evidence which I am sure I will come back to in future blog posts. Overall it paints an unsurprising picture of hospital care which won’t create headlines because it doesn’t tell a story of cruelty or obvious abuse – although there is evidence that some of these hospitals remain scary and sometimes dangerous places. There is also cause for cheer as important upgrades are progressing – for example the end is apparently in sight for beds without en suite facilities.

But the report still leaves me deeply frustrated. To understand why let me point to two bits of hard evidence in the report…

  • Proportion of Welsh patients in NHS medium secure hospitals recorded as having attended planned activities at the time of audit: 3% – that’s just 1 in 30
  • Average weight gain of Welsh patients (all secure hospitals) since admission: 6.2 kg – that’s about one stone (for high secure patients it’s about 2.5 stone)

See where I’m going here?

Yes, this doesn’t sound like a service which is therapeutic. On the contrary it sounds like a boring, unstimulating place to be locked up where you won’t do much and the enforced indolence will damage your physical health to the point that you may live less long.

Now patients’ voices are heard in the report and they don’t complain much about the staff. But to be honest I’d be happier if patients reported that staff were regularly on their case getting them active mentally and physically – that means really helping patients to recover rather than just waiting for them to recover.

Some of the recommendations in the report are okay as far as they go but I don’t see there what I want to see – a revolution in hospital care which turns it into a dynamic service which isn’t an easy option (for patients or staff) but one which would actually challenge patients to progress their  recovery and reward staff with the satisfaction of achieving success.

Easy to say? Well, I also have some practical ideas to make this happen:

  • Engage staff and volunteers with lived experience at all levels – as therapists, managers, and commissioners
  • Benchmark best practice in Wales and beyond – and roll that out systematically
  • Compare outcomes, quality, and costs of both NHS and other providers – and commission what works best irrespective of who provides it
  • Develop real patient choice – including choice of which hospital they go to

And I can’t finish without a reminder that this NHS report does not give a complete picture: never forget all those suffering in prison with psychosis and other debilitating symptoms of serious mental illness. The scandal continues.

Jo Roberts is a mental health campaigner who was on the receiving end of the Mental Health Act for over 30 years. In the past she has received compulsory treatment; some of that treatment was deeply unpleasant and even terrifying. Jo is campaigning for a progressive Mental Health Act fit for the 21st Century – an Act that gives patients and carers in Wales and beyond a fairer deal.