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News ArticleUnregulated healthcare workers are a risk to the most vulnerable patients, a former victim’s commissioner has warned after The Independent and Sky News uncovered a “horrifying” sexual abuse scandal within NHS mental health services. Dame Vera Baird called for a formal framework for healthcare assistants and support workers, who do not have a mandatory professional register like doctors and nurses and can “come in and go out from one hospital to another” without the same thorough checks. Dame Vera told The Independent that the setup did not lead to a “very safe way of working” because healthcare assistants are “in an environment where they are responsible for vulnerable people”. “If there has been abuse from mental health care assistants who are also agency staff who are coming in and going out from one hospital to another, that needs to be looked at,” she said. “This is not a very safe way of working. Some kind of framework around agency staff seems to be very important [to have].” She warned that sexual predators may go into mental health services and work in units where patients can be “highly sexualised”, prompting a “dreadful combination”. Read full story Source: The Independent, 30 January 2024
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Content ArticleThis document from the Department of Health and Social Care (DHSC) sets out how health and care systems should work together to support discharge from all mental health and learning disability and autism inpatient settings for children, young people and adults. It sets out best practice on: how NHS bodies and local authorities should work closely together to support the discharge process and ensure the right support in the community, and provides clarity in relation to responsibilities patient and carer involvement in discharge planning.
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Content Article
Patient 11: Sky News podcast series (28 January 2024)
Patient Safety Learning posted an article in Mental health
Young mother and former GB youth swimmer, Alexis, agrees to enter NHS England psychiatric care following a family tragedy. She could never imagine that her three-day admission will turn into a three-year ordeal. Then undiagnosed with autism, and often the subject of 24-hour surveillance as well as long periods in solitary confinement, Alexis descends to the darkest reaches of locked-in, psychiatric care. There, she encounters the kind of threat she never could have imagined in a secure mental health hospital. In a bid to break free, Alexis plots a daring escape. This series discusses rape and sexual assault. -
News ArticleTens of thousands of sexual assaults and incidents have been reported in NHS-run mental health hospitals as a “national scandal” of sexual abuse of patients on psychiatric wards can be revealed. Almost 20,000 reports of sexual incidents in the last five years have been made in more than half of NHS mental health trusts, according to exclusive data uncovered in a joint investigation and podcast by The Independent and Sky News. The shocking findings, triggered by one woman’s dramatic story of escape following a sexual assault in hospital revealed in a podcast, Patient 11, show NHS trusts are failing to report the majority of incidents to the police and are not meeting vital standards designed to protect the UK’s most vulnerable patients from sexual harm. Throughout the 18-month investigation, multiple patients and their families spoke to The Independent about their stories of sexual assault and abuse while locked in mental health units. Dr Lade Smith, president of the Royal College of Psychiatrists, called the findings “horrendous”, while shadow health secretary Wes Streeting said it was a “wake-up call” for the government. Dr Smith told The Independent: “There is no place for sexual violence in society, which has a profound and long-lasting negative impact on people’s lives. Today’s horrendous findings show that there is still much to do to make sure that patients and staff in mental health trusts are protected from sexual harms at all times. “It is deeply troubling to see that so many incidents in mental health settings go unreported.” Read full story Source: The Independent, 29 January 2024
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News Article
NHS trust ‘abandoned’ budding paramedic who took her own life
Patient Safety Learning posted a news article in News
Rebecca McLellan, a trainee paramedic, pursuing the job she had dreamed of as a child, took her own life at the age of 24. Amid the devastation felt by her loved ones, serious questions have now emerged about the standard of care she received at Norfolk and Suffolk NHS Foundation Trust (NSFT). In notes recorded before her death last November, McLellan said that Norfolk and Suffolk NHS Foundation Trust (NSFT) had “abandoned” her in a time of need. An internal investigation has now been launched by the mental health trust, which has been dogged by safety concerns for more than a decade. Relatives of McLellan, who lived in Ipswich, Suffolk, and was being treated for bipolar disorder, are among hundreds of bereaved families who believe their loved ones were failed under the care of the trust. Her mother, Natalie McLellan, 48, said it was clear that some of her daughter’s feelings of helplessness in her final months were “shaped by their inadequacy”. “She was somebody that had it all,” said Natalie. “She had a supportive family, she had a nice flat, she had a nice car, she was doing exactly what she wanted to do in life. She had a voice, she was able to speak and advocate for herself as a medical professional. If she can’t get help, what the hell hope is there for anybody else? Recent months have seen calls for a public inquiry and criminal investigation into NSFT after bosses last year admitted to losing count of the number of patients that had died on its books. Campaigners describe the mismanagement of mortality figures as “the biggest deaths crisis in the history of the NHS”. The Times has spoken to trust staff, bereaved relatives and MPs who say that despite repeated promises of improved care the trust’s overstretched services remain unsafe and require urgent reform. Read full story (paywalled) Source: The Times, 26 January 2024 -
News ArticleCampaigners have said that more lives would be lost unless mental health services were reformed. Figures show 120 people each year are killed by people with mental illnesses. Julian Hendy, whose father was killed by a psychotic man with a long history of mental ill health 17 years ago, said health professionals must be “more assertive” and work better with other agencies such as the police. Valdo Calocane, who was sentenced on Thursday to an indefinite hospital order after being convicted of manslaughter of three people in Nottingham, had fallen off the radar of mental health services, which allowed him to avoid taking his medicine. Hendy accused Nottinghamshire Healthcare NHS Foundation Trust, which was responsible for Calocane’s care, of “washing their hands” of him. He said: “It’s not responsible and it’s not safe. It doesn’t look after people properly … That hasn’t helped him at all, or protected his rights at all, because he has now committed this terrible offence.” Read full story (paywalled) Source: The Times, 26 January 2024
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Content ArticleSarah Rainey talks to Olivia Djouadi about her experience of type 1 diabetes with disordered eating (T1DE), which is thought to affect up to 40% of women and 15% of men with type 1 diabetes. People with T1DE, sometimes also called diabulimia, limit their insulin intake to control their weight, which can have life-threatening consequences. Olivia describes how the stress of living with type 1 contributed to her developing T1DE, and how when she finally received treatment and support in her 30s, she was able to deal with her disordered eating and see her health and wellbeing improve.
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Content Article
Suicide by female nurses: a brief report (June 2020)
Patient Safety Learning posted an article in Staff safety
This report, authored by the National Confidential Inquiry into Suicide and Safety in Mental Health (NCISH), was commissioned by NHS England/NHS Improvement in response to a report by the Office for National Statistics that identified female nurses as having a risk of suicide 23% above the risk in women in other occupations. This was a brief study aimed to establish preliminary data about women who died by suicide while employed as nurses. To do this, NCISH carried out an examination of Office for National Statistics (ONS) data on female nurses who died by suicide during a six-year period (2011-2016) was carried out with a detailed analysis of female nurse suicides using the NCISH database of people who died by suicide within 12 months of mental health service contact, including comparison with other female patients.- Posted
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News ArticleThe Campaign to Save Mental Health Services in Norfolk and Suffolk is calling for a criminal investigation into an apparent scandal that decisively surfaced over the summer, centred on the Norfolk and Suffolk NHS foundation trust (or NSFT), which sees to mental health provision across those two very large English counties. It is centred on the “unexpected” deaths of 8,440 people between April 2019 and October 2022, all of whom were either under the care of the trust, or had been up to six months before they died. The story of the failures that led to that statistic date back at least a decade; the campaign says it amounts to nothing less than “the largest deaths crisis in the history of the NHS”. The figure of 8,440 was the key finding of a report by the accounting and consultancy firm Grant Thornton – commissioned by the trust, ironically enough, to respond to anxious claims by campaigners, disputed by the trust, that there had been 1,000 unexpected deaths over nine years. There are no consistent national statistics for such deaths, and no universal definition of “unexpected”: in Norfolk and Suffolk, a death will be recorded as such if the person concerned was not identified by NHS staff as critically or terminally ill; the term includes deaths from natural causes as well as suicide, homicide, abuse and neglect. The period in question includes the worst of the pandemic, although the trust’s own annual deaths figures did not reach a peak until 2022-23. But the numbers still seem jaw-dropping: they represent an average of about 45 deaths a week. To put that in some kind of perspective, earlier reports about the trust’s deaths record had raised the alarm about a similar number of people dying every month. And the Grant Thornton report included another key revelation: the fact that the trust’s record-keeping was so chaotic that in about three-quarters of cases, it did not know the specifics of how or why the people concerned had died. After its publication, moreover, there were more revelations about the trust, and its culture and practices. Read full story Source: The Guardian, 21 January 2024
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Content ArticleThis animation was created to highlight the specific issues for people with learning disabilities in relation to psychological trauma.
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Content ArticleThis study in JAMA Psychiatry aimed to assess whether multivariate machine learning approaches can identify the neural signature of major depressive disorder in individual patients. The study was conducted as a case-control neuroimaging study that included 1801 patients with depression and healthy controls. The results showed that the best machine learning algorithm only achieved a diagnostic classification accuracy of 62% across major neuroimaging modalities. The authors concluded that although multivariate neuroimaging markers increase predictive power compared with univariate analyses, no depression biomarker could be uncovered that is able to identify individual patients.
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News ArticleOne of Britain’s three high-security hospitals – where notorious people including Ian Huntley and Charles Bronson have been detained – is so understaffed that neither workers nor patients are safe, a damning new report has found. Rampton Hospital in Nottingham faces severe staff shortages, leading workers to restrain patients and lock them away in their rooms and putting patients at risk of self harm, according to the Care Quality Commission. In a report looking into the hospital, inspectors – who rated the hospital as inadequate – said there were around half the staff needed on one ward. In one example of those at the hospital being at risk, a patient self-harmed with glass from their watch, while another was able to harm themselves with a CD while they were confined to their room. One deaf patient was secluded several times on another ward for “being loud”, according to the CQC. “We spoke with people in the learning disabilities services who told us they sometimes get locked in their room from dinner time until the next morning,” the report said. “They told us that they don’t like being locked in their rooms.” Read full story Source: The Independent, 17 January 2024
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Content ArticleCoercive or restrictive practices such as compulsory admission, involuntary medication, seclusion and restraint impinge on individual autonomy. International consensus mandates reduction or elimination of restrictive practices in mental healthcare. To achieve this requires knowledge of the extent of these practices. This study is the most comprehensive overview of rates of coercive practices between countries attempted to date.
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Content ArticleAfter an extreme traumatic event there are things that you can do to help yourself, and your colleagues, to move on. Fiona Day, medical and public health leadership coach and chartered coaching psychologist, Stacey Killick, consultant paediatrician at Glan Clwyd Hospital, and Lucy Easthope, professor in practice at Durham University’s Institute of Hazard, Risk, and Resilience and adviser on disaster recovery give their tips in this BMJ article.
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News Article
Thousands of mental health patients readmitted within a month in England
Patient Safety Learning posted a news article in News
Thousands of patients are being readmitted to NHS mental health units in England every year soon after being discharged, raising concerns about poor care, bed shortages and increased risk of suicide. Experts say being discharged prematurely can be upsetting, set back the patient’s chances of making a full recovery and be “disastrous” for their health. Figures from NHS mental health trusts in England show that last year almost 5,000 people – children and adults – were readmitted to a mental health facility within a month of leaving. The Labour MP Dr Rosena Allin-Khan said the “alarming” data, which she obtained under freedom of information laws, showed too many patients were not receiving enough help to recover. Allin-Khan said: “With record waiting lists and mental health beds in short supply, it is alarming that many patients are being discharged only to be readmitted within days. Every patient expects to receive full and appropriate mental health support, so it is concerning that in many cases patients are being discharged prematurely. “Being discharged too soon can have a disastrous impact, stunting progress towards a full recovery, ultimately causing further damage to a patient’s mental health.” Read full story Source: The Guardian, 12 January 2024 -
Content ArticleIn the challenging journey of addiction recovery, trust is a cornerstone of success. For individuals seeking help and the healthcare providers who guide them, it forms the bedrock upon which every aspect of treatment rests. Therefore, building trust in addiction treatment is a vital component that can determine the course of recovery.
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News ArticleWomen who experience depression during pregnancy or in the year after giving birth are at a higher risk of suicide and attempting suicide, researchers have warned. The British Medical Journal study warned that women who develop perinatal depression are twice as likely to die compared to those who don’t experience depression. Suicide was the leading cause of death for women in the UK in 2022 between six weeks and one year after birth, while deaths from psychiatric causes accounted for almost 40 per cent of maternal deaths overall, according to a Perinatal Mortality Surveillance report. Last year an analysis by Labour revealed 30,000 women who were pregnant were on waiting lists for specialist mental health support. The number of women waiting rose by 40 per cent between August 2022 and March 2023. The most recent NHS data shows in September 2023, 61,000 women accessed perinatal mental health services. For 2023-24, the health service must hit a target to have 66,000 women accessing care. In August 2023, the Royal College of Midwives published a research warning half of anxiety and depression cases among new and expectant mothers were being missed amid NHS staff shortages in maternity care. Read full story Source: The Independent, 11 January 2024
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Content ArticleThis study published in the BMJ found that women with clinically diagnosed perinatal depression were associated with an increased risk of death, particularly during the first year after diagnosis and because of suicide. Women who are affected, their families, and health professionals should be aware of these severe health hazards after perinatal depression.
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News Article
New mothers being driven to suicide, senior midwife warns
Patient Safety Learning posted a news article in News
The senior midwife tasked by the government and NHS to investigate serious maternity scandals has warned that new mothers are being driven to suicide and backed an MP’s review into birth trauma. Donna Ockenden said it was “appalling” that women who should be in the “happiest times of their lives” were taking their own lives, after it was found suicide was the leading direct cause of deaths up to 12 months after giving birth. Ockenden, who has exposed poor maternity care across the country, is preparing to give evidence to an inquiry launched by Theo Clarke, the Conservative MP for Stafford, on birth trauma. Clarke thought she was going to die after giving birth to her daughter Arabella last year, having suffered a third-degree tear. But it was the lack of help available that opened her eyes to the estimated 200,000 women a year who experience birth trauma. Ockenden told The Times she had “huge respect” for Clarke’s inquiry and said: “I think that this whole issue of maternal trauma, sometimes long-term psychological trauma for families as well post a difficult maternity experience, is not necessarily given enough air time.” Read full story (paywalled) Source: The Times, 8 January 2023 -
Content ArticleMorgan-Rose Hart died after she was found unresponsive while being detained under section 3 of the Mental Health Act at the Derwent Centre at the Princess Alexandra Hospital in Essex. Morgan-Rose was last clinically observed at 14.06 on 6 July 2022 and in between the last observation and when Morgan-Rose was discovered the Coroner notes that multiple failings in her care took place, including consecutive hours observations being incorrect and falsified.
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Content ArticleThis rapid evidence review and economic analysis makes the business case for investing in the wellbeing of NHS staff. It was written by a team from the University of East Anglia, RAND Europe and the International Public Policy Observatory (IPPO) and includes a narrative review of data on the current state of the mental health and wellbeing of NHS staff. Data shows that nearly half of staff reported feeling unwell as a result of work-related stress in the most recent survey, that sickness absence has increased and that there are high vacancy and turnover rates in some trusts. Research also shows that patient care can be affected by poor healthcare staff wellbeing.
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Content ArticleThe evidence presented in this report makes the undeniable case that people living with a mental health condition and taking medicines need better access to the expertise of pharmacists across the whole spectrum of care.
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News Article
GPs to offer more mental health support for mothers in England after giving birth
Patient Safety Learning posted a news article in News
Mothers in England will be asked in detail if pregnancy or giving birth has affected their mental health as a result of new NHS guidance to GPs. The move is part of a drive by NHS England to improve support for women suffering postnatal depression or other mental health problems linked to their pregnancy or childbirth. Under the new guidance GPs will ask women more questions than before about how they are feeling when they attend their postnatal health check six to eight weeks after giving birth. Family doctors will look for any sign that the woman may have a condition such as postnatal PTSD as a result of experiencing a traumatic birth or psychosis induced by bearing a child. Anyone who the GP feels needs help with their mental wellbeing will be referred to specialist maternal mental health services, which have been expanded in recent years. Read full story Source: The Guardian, 18 December 2023 -
News Article
Calls for police to investigate mental health deaths in Norfolk and Suffolk
Patient Safety Learning posted a news article in News
Campaigners have written to the chief constables of Norfolk and Suffolk to request an investigation into thousands of mental health deaths in those areas. They say coroners are raising safety issues but no improvements are being made. A report by independent auditors found as many as 8,440 patients had died unexpectedly over three years. Norfolk and Suffolk NHS Foundation Trust said it had started a review of patient deaths. Coroners worried about the risk of future deaths highlight unsafe practices in prevention of future deaths reports (PFDs). And authorities are required by law to respond with an action plan within 56 days. The Norfolk and Suffolk trust said it had responded to all PFDs and was working to ensure recommendations and actions were implemented. But Mark Harrison, from the Campaign to Save Mental Health Services in Norfolk and Suffolk, said: "There's a criminal case to answer. And we want the police to investigate, where the same mistakes have been repeated time and time again." He said coroners were repeatedly warning of risks such as delays to treatment, lack of patient follow-ups, chaotic record keeping and disorganised communication between teams. Mr Harrison said: "The mental health trust always responds saying they've learned lessons, they are changing policy and practices. "But then what we're seeing in analysing the orders from the coroner are repeat circumstances where other people have died in similar circumstances to a previous prevention-of-future-deaths notice." Read full story Source: BBC News, 12 December 2023 -
Content ArticleMr Malone was diagnosed with treatment resistant schizophrenia in 1983 and had been sectioned multiple times. In May 2023 he was diagnosed with adult autism. At a review on 31 May he was considered to be stable. On 15 June a routine clozapine review identified sub-therapeutic levels but this was not notified to his clinicians. Sub-therapeutic levels of clozapine are likely to have contributed to a worsening in his symptoms. Around 24 June he was noted to have suffered a significant deterioration – with symptoms of thought disorder, anxiety, and responding to hallucinations – and following a mental health act assessment on 28 June clinicians wanted to detain him under section 2. No inpatient psychiatric bed was available. Whilst he awaited a bed, he remained in the community with daily visits from the mental health team. Last contact was on 1 July when he accepted his medication and appeared more settled. There was no answer when he was visited on 2 July. His room at supported accommodation was entered on 3 July and he was found deceased. Recently he had expressed no suicidal ideation. Post-mortem examination confirmed the medical cause of death was: 1a Cervical spinal cord injury. 1b Laceration. The conclusion of the inquest was that death was the consequence of suicide.
