Carers of people with mental health problems come into contact with different hospitals departments. If people with mental health problems are very unwell and considered a danger to themselves or others they will be admitted to an NHS psychiatric hospital. Admission can be voluntary or compulsory through being ‘sectioned’ under the Mental Health Act. The law says that the view of the nearest relative should be considered when a person is admitted to a psychiatric ward. It is also possible to have private health insurance and use private psychiatric hospitals.
Hospital outpatient departments are used by those who need treatment but don’t need to be admitted to a psychiatric ward. Some carers we spoke to had to take their relative to an Accident and Emergency department after serious injuries or suicide attempts.
Treatment in psychiatric wards
Many carers said that, when people are very unwell, they are safest and best looked after in hospital. These carers thought it important to work together with medical staff. Some said they trusted the expertise of the hospital staff and were relieved to have some responsibility taken off them.
Leah is happy with her son’s consultant and trusts her (recording in Chinese).
Her son complains about the nurses, but she is grateful to the medical staff (recording in Chinese).
Other carers, however, didn’t think people could really get better in psychiatric wards. Some said that people who were in psychiatric hospitals long-term were ‘just locked away’ with very little to do. One woman asked ‘how can you have so many people sitting around smoking and watching TV – do they think it is worth sectioning people for that?’ And she wondered’ ‘how does that equip you for when you leave?’
Raye says her sister, like many other people from minority ethnic communities, has become…
People also said that hospital care seemed mostly to involve medication, and that there was not enough psychotherapy or activities to occupy patients, or spiritual care.
Nicks son has had little psychotherapy; and he thinks there is a dearth of psychotherapy in…
Angela thinks people with mental health problems need a firm hand and spiritual care.
Some carers worried about the safety in psychiatric wards. One person’s elderly aunt, who had dementia, had been sexually abused by another patient. Based on her own experiences, another carer felt her father wasn’t safe in hospital.
Having been attacked herself, Elaine worried about her father when he was in hospital (played by…
Resources vs. the duty of care
Some talked about a lack of resources in mental health services, which meant that wards were understaffed, or unqualified personnel were used to save money. Carers had sympathy with hospital staff because of their demanding jobs, including ‘being shouted at’ and the ‘risk of being beaten up’. They also mentioned the long shifts and ‘poor pay for nurses’. But they also felt that hospitals should take their duty of care seriously, and not hide behind ‘restricted resources’. For example, some said the food in hospital didn’t suit people’s diet and was unhealthy. Since ‘healthy eating is not rocket science,’ hospital food could be made more nutritious and culturally appropriate.
People also talked about neglect, such as their loved ones not being changed or fed as often as they needed, their medication being wrong or left untouched, people getting dehydrated as well as a lack of privacy and dignity.
Ramila thinks people with mental health problems should be given the privacy of their own room.
People with mental health problems in general hospital wards
People with mental health problems sometimes need hospital treatment for physical conditions and are sometimes moved between general wards and psychiatric wards. Some carers reported a lack of communication between different wards or between hospitals, which sometimes meant people missed out on treatments, or were not seen as ‘whole persons’. Lack of communication between services meant carers often knew more about the situation that the professionals involved.
Elaine’s father was sectioned and moved from the general ward to the psychiatric ward against her…
The psychiatric ward could not provide all the treatment her father needed and did not have notes…
Many carers talked about how general hospitals wards ‘did a good job clinically’ but didn’t have the resources to look after people with mental health problems. One man even commented: ‘If you ever get sick, don’t go to hospital, they are dangerous places!’ Some therefore felt they needed to be involved in hospital care to make sure their loved ones were safe and treated well. One carer thought her father wouldn’t have survived had it not been for her nursing background.
She felt staff had given up on her father and so she intervened (played by an actor).
While in hospital for observation after suffering a seizure, another carer’s husband (who had dementia) did not get out of bed for a week, and couldn’t stand up when he came home. Since then, both have been housebound because of his immobility.