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Tuesday, August 3, 1999 Published at 15:35 GMT 16:35 UK


Health

CS gas used on psychiatric patients

Conditions at some hospitals were said to be unacceptable

Mental health services have come under fire in an independent report that raises concerns on a range of issues - not least the use of CS gas to restrain patients on the wards.

The review also expressed concerns about the level of drug abuse on the wards and high level of use of the act to detain people from ethnic minority backgrounds.

It criticised low levels of interaction between carers and patients and low levels of staffing.

The review - the eighth biennial report of the Mental Health Act Commission - is published on the eve of the government's review of mental health services.

Significant failings

Gordon Lakes, acting chairman of the commission, said: "It is a fundamental principle that those subject to compulsion by reason of a mental disorder should be assured of an appropriate standard of care and treatment."

He said many of the units the commission visited over the last two years had been able to provide this.

"But a significant number do not and some fail to provide even an acceptable level of service," he said.

Mental health campaigners said they were appalled by the state of services exposed in the report, and have called for an end to the "culture of control without care".

Staff shortages are leading to "coercive forms of restraint and control", according to the mental health charity Mind.

Restraining method

The report expresses concern over one technique - the use of CS gas on psychiatric wards by police officers called in to deal with disruptive patients.

"It is understandable that when the police are called in to deal with potentially dangerous situations on psychiatric wards or in the community, they will expect to be able to adopt what they regard as the most practical and safest methods of control," it said.

"On the other hand, because of its ease of use, there is a concern that police may be inclined to use CS spray not as a last resort and in place of other less potentially harmful techniques."

It said studies were needed to establish how CS gas interacts with psychiatric medicines, and the effects of using it in enclosed spaces.

Criticisms

The report's other main findings were:

  • Nearly a third of all psychiatric patients were detained under the Mental Health Act
  • There is a continued shortage of beds, leading to delays in patients getting the treatment they need
  • Nurses are often "too busy" to spend time with patients - this was found to be the case at a quarter of the 309 wards the commission visited on its first surprise visit
  • Patients frequently complained of lack of access to fresh air and activities
  • There were concerns over the safety of women detained on mixed wards - the commission calls for steps to ensure "privacy, dignity and safety"
  • There was a "general difficulty" in getting hold of a doctor to offer a second opinion
The commission also looked at details of all unnatural deaths of detained patients.

"These raise issues of concern about risk assessment, observation levels, leave of absence without leave arrangements and ward security," the report said.

Call for government action

A spokeswoman for Mind said the group was extremely concerned by the findings and would be calling on the government to speed up its review of services.

In particular, the charity was concerned about the increasing use of CS gas - about which it had received many complaints from patients - and inadequate levels of staffing.

Judi Clements, chief executive of the charity, said: "Today's report highlights a very worrying number of psychiatric wards that have to operate a culture of control not care.

"Patients are entitled, as the commission's acting chairman states, to a 'safe, calm and therapeutic environment' yet this report shows that hospital are too often failing patients on all counts."



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