Funding 'real threat to nursing'

Nurse Mamade Chattun died of his injuries

The trial into the killing of a nurse by schizophrenic patient Jason Cann has called into question safety within psychiatric hospitals.

Cann, 22, was convicted of Nurse Mamade Chattun's manslaughter and was ordered to be sent to Broadmoor Hospital indefinitely.

Mamade Chattun, 43, was beaten to death by Cann in the lobby of Tooting's Springfield Hospital, in June 2003.

However, campaigners say events such as the Cann case are rare and the overwhelming majority of mentally ill people pose no risk.

They say the real threat to mental health nursing is underfunding, not the patients.

Too many wards remain overcrowded and understaffed due to historical underinvestment and stigma, they say.

Assessing risk

Ian Hulatt, mental health advisor at the Royal College of Nursing, said: "There are risks and the Cann case clearly demonstrates that.

Violence among these patients is very rare. Andy Bell, of the Sainsbury Centre for Mental Health

"But there are processes. Staff do risk assessments to judge what risk the client might pose both to themselves and to others.

"Staff can then put measures in place to protect the client and others."

He said it was vital that all members of the team caring for clients were aware and clear about any potential risks.

"Nurses and health professionals also need to be trained how to defuse and de-escalate situations."

He said impending guidelines for healthcare professionals on the management of violence and aggression and new curricula should help with this because current provision was "patchy".

Resourcing strains

He said other nursing professions would also benefit.

"I would rather be on an admission ward on a Friday night in an acute psychiatric unit than in an A&E department.

"Our colleagues in A&E have an equally, if not more difficult time dealing with people who are intoxicated."

Too many psychiatric wards remain overcrowded, unhygienic, chaotic and run-down. Paul Corry of Rethink 'Psychiatric services failed me'

But he thought current strains on psychiatric services, such as staff shortages, increased the risk of violence.

"The environment people are cared for in impacts on their behaviour."

Paul Corry of Rethink said: "Too many psychiatric wards remain overcrowded, unhygienic, chaotic and run-down.

"The stigma of mental illness affects professionals who may fear for their career prospects, meaning that serious staff shortages also persist.

"The government has taken some steps to end the historical underinvestment in mental health services.

"Much more investment is needed to make them safe and supportive places for both patients and staff."

Andy Bell, of the Sainsbury Centre for Mental Health, said: "People with mental health problems are not a significant risk to people's safety.

"Violence among these patients is very rare and the number of homicides is a minute proportion of all homicides every year."

The government is proposing changes to mental health legislation that would allow enforced treatment of potentially dangerous mental health patients were concerning.

Mr Bell said: "Everyone in the mental health community is extremely alarmed at the idea that there are plans set out that will increase the number of people treated against their will either in hospital or the community.

"That will increase pressure on mental health services, particularly acute services."