Mental health inpatient environments 'some of the worst in the NHS'

Independent review committee looking to reform Mental Health Act dubs services 'risk averse' and 'institutional' and calls for urgent capital investment

An independent review panel is calling on the Government to increase the capital budget for mental health facilities, labelling current inpatient environments as ‘some of the worst in the NHS’.

In their newly-published report, Modernising the Mental Health Act, the committee slammed current inpatient accommodation as ‘institutional’, accused planners of being overly ‘risk and infection averse’, and called for additional funding.

Providing an overview of the current issues, and setting out a series of recommendations for improvement; the document states: “There is no simple solution, but we do seriously want to rebalance the system to be more responsive to the wishes and preferences of the patient, to take more account of a person’s rights, and to improve, as much as possible, the ability of patients to make choices, even when circumstances make this far from easy.”

The physical environment of wards has become affected by an increasingly risk- and infection-averse approach, which can create the kind of institutional atmosphere that psychiatry has been trying to move away from for the last half century

In a section dedicated to inpatient environments, the review committee states: “Wards become people’s homes, often for many months, and so should offer a positive community for the patient where they can build new relationships.

“Sadly, people are often placed in some of the worst estate that the NHS has, just when they need the best.

“The physical environment of wards has become affected by an increasingly risk- and infection-averse approach, which can create the kind of institutional atmosphere that psychiatry has been trying to move away from for the last half century.

“We, therefore, call for new capital investment by the Government and NHS to modernise the mental health estate.

“We argue that ward environments and ward cultures alike should support independence, social interaction and activity. These are all key to enabling people to get better.”

Also recommended in the report are additional ‘health-based places of safety’ for use instead of police cells.

It states: “Where they do not currently exist, health-based places of safety will need to be commissioned.

“We also recommend that courts should not remand to prison solely on the basis that it is a safe place for such people to be, for it simply is not.”

These comments, if acted upon, will call for a major investment in the mental health estate, to bring current facilities up to standard, and to increase capacity, and to provide new buildings to address the growing pressure on services.

We argue that ward environments and ward cultures alike should support independence, social interaction and activity. These are all key to enabling people to get better

The report concludes: “This review will not, and cannot, deliver a perfect system. That is impossible, not least because there is no agreement on what it should be.

“What it does, however, aspire to deliver is a much-improved system that, at its core, places the patient in higher esteem.”

The NHS Long-Term Plan, launched in January, sets out proposals to vastly improve mental health services.

These included a renewed commitment that mental health services will grow faster than the overall NHS budget, with the creation of a ring-fenced local investment fund worth at least £2.3billion a year by 2023/24.

And, the Government earlier announced an allocation of £3.9billion to accelerate estates transformation across the NHS.

It is expected that the Chancellor will give more detail on where this money will be spent in his upcoming Spending Review.