The Guardian 27 October 2010
Health regulator says blanket measures introduced in the name of patient security may infringe human rights law
The Care Quality Commission said the proportion of people in low secure beds has increased significantly since 2006. More than a quarter of psychiatric patients are now in held in low secure units (LSUs). Three years ago, the figure was less than a fifth.
Such changes in the pattern of care have rung alarm bells at the commission. It says patients were being subjected to a regime of close observation behind high fences and “airlocks”, where patients sometimes faced “unsafe or abusive practices”.
The regulator cited cases where the mentally ill were limited to “two to six sheets” of toilet paper and where nurses were unable to administer care because they were busy guarding patients.
One example saw a male nurse assigned “to preserve the dignity” of a highly disturbed female patient who was constantly attempting to remove her clothing. Other female patients in a different unit also complained that male nurses were involved “during night-time observation, bathing and toileting”.
The commission said these were “serious concerns for the dignity and safety of vulnerable [people]”. “Examples of poor practice being followed in the name of patient security included blanket measures that risked infringing human rights law, and disregard for privacy and dignity that was verging on unsafe or abusive practice,” said the report.
There had also been an alarming trend of security measures that banned mobile phones or forbade patients from preparing their own meals. The commission said, in some circumstances, this could “amount to an unwarranted infringement of patients’ ECHR article eight rights to a family and private life”.
The commission recommends reviewing the national policy of standards in such units. Matt Kinton, the report’s author, said there was a “real worry that the more mental health wards look like prisons, the less they function as hospitals where people will get better and be able to live independently”.
Kinton said one of the driving forces of this trend towards security was that the private sector had built many new low-security wards. “It is the old adage that if you build a hospital, patients will fit it.”
The regulator also noted that there was a sharp rise in the doctors prescribing compulsory treatments for mental health problems. On average, 367 community treatment orders (CTOs) have been made each month. This is at least ten times the number anticipated when the legislation was introduced in 2008.
Patients detained in hospital can be discharged under CTOs and supervised by a doctor who stipulates a strict prescription of medicines and can sometimes restrict patients movements. If a patient refuses, they can be returned to hospital.