I was struck by a sense of deja vu reading this article. To put it bluntly, the vile abusive crappy crap ‘care’ people in the psychiatric system continue to receive.
The Mental Health Act Commission claims many more patient deaths will occur through inadequate staffing and lack of training.
Inadequate staffing, lack of training, falsification of records regarding suicides, over-usage of physical restraint, sexual harassment and abuse in mixed wards, violence, unsafe environments, children and teenagers ending up in adult wards.
The report – Coercion and Consent: Monitoring the Mental Health Act 2007-2009 – describes the routine in one East Midlands unit of stripping women patients naked, to ensure they are not concealing any means for inflicting self-harm, as undignified and contrary to codes of practice.
Acute psychiatric wards are singled out for abrasive attention: a year-long consultation with psychiatrists, service users and carers “confirmed our criticisms in stating that many inpatient units are unsafe, overcrowded and uninhabitable”.
When I was very active in the mental health user movement during the 1990s all of the issues above were voiced time and time and time and time again. We campaigned and lobbied. Told things would change but as you can see nothing has changed. The promise of single sex wards but as you see that hasn’t materialised, and again, this report exposes that women are experiencing sexual harassment and sexual assaults which creates more vulnerability, powerlessness and further impacts on a woman’s mental health. I remember some years ago hearing about women on a particular mixed psych ward would sleep two to a single bed, they would take it in turns to sleep while the other would stay awake and be vigilant to defend themselves against any harassment or abuse (and rapes and other sexual assaults). That shocked me to the core, changes were promised but I don’t think anything did.
And one patient found hanging in 2007 was reported to show signs of rigor mortis (not usually noticeable until around three hours after death),” the commission notes, “despite … being subject to 15-minute observations.”
That reminded me of a young man who had been sectioned under the MH Act, he had told his parents he would commit suicide if he was sectioned. His parents didn’t want him sectioned but the professionals went over their heads yet told them he would be under constant obs. He hanged himself while supposedly on a 15 mins obs. I met his parents, they were grief stricken and bereft… and to add insult to injury some of his notes were missing ….. Strange that!
The treatment of people within the psychiatric system is dehumanising, humiliating and degrading. You are continuely treated as a problem, punished through containment and coercion. You have little control and so many people have immense power over you especially if you are on a section. And that power is wide open to neglect and abuse.
I have witnessed people being physically restrained (it is barbaric to see) during the late 1980s, and in 2009 they still are using oppressive restraint techniques when alternatives should be used.
It sickened me reading about women being stripped in a East Midlands unit to make sure they are not concealing any means for inflicting self-harm (and whether they had a history of self-harm is neither here nor there…it’s still humiliating and degrading!!).
But the mind boggles…. this is wholesale degradation and humiliation. And this ‘procedure’ goes against codes of practice, yet why aren’t the regulations enforced? Where are the safeguards, protection, rights and freedoms for these women? It is abusive and invasive but again not new. Time and time again, mainly women mh users, have been subjected to these intrusive and abusive assaults especially if she has been self-harming. So instead of trying to understand why she is resorting to self-harming behaviour she is punished by having her room stripped and would be searched for implements that could be used to inflict self-injury.
I recall arguing with a professional based at a special hospital about this. I said that self-harm was about lack of control over life and powerlessness. And therefore punishing a woman by stripping her room and searching her would only amount to further feelings of powerlessness and lack of control (they would also put her in what can only be described as solitary confinement). Wouldn’t it be better to establish what the triggers are and make sure staff are available for the woman to speak to, it may also build trust? That suggestion was shrugged off as it was about punishing the woman who self-harmed (behaviourist tactics) and same treatment pretty much meted out to women who had an eating distress.
It’s late, I am suffering from insomnia and reading this report is soul destroying. In some ways, years on, I still feel haunted by some of the things I witnessed, experienced and heard while a patient in a psych hospital and later, active within the mental health user movement. That’s one of the many reasons I became active as I wanted to see change, challenge the rigid abusive system that treats people by punishing, coercing and containing them. And humilaiting and degrading us as if we are beyond contempt. Where abuse, squalid behaviour and neglect is hidden and/or covered-up, the guilty go unpunished while the victims remain silenced and traumatised. Like we don’t matter, like we are invisible, like we don’t deserve justice. Or dignity, or to be treated like an equal human being, to regain power, control and wholeness.
And the response is usual:
Baroness Young, chair of the Care Quality Commission, endorsed the commission’s critique but said that mental health care was “one of the most difficult areas of care in this country. It’s never going to be an easy area.”
She called for “proper accredited schemes” to train hospital staff in safe restraint techniques and deplored staff shortages in mental health units that restrict activities for patients. “If they don’t have enough stimulus, it’s a pretty nihilistic [life].”
You need to go beyond staff shortages and training. There needs to be overhauling of the psychiatric system, the adherence to the medical model along with its ideology as well. Just superficial changes will carry on replacating the same old abusive system. Sorry if I sound harsh and seen as too critical (though there are pockets of good practice few though and far between) but the mental health system damages people more than it ‘cures’…
Download report here.
