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Alison Gadsby: ‘We need to rethink mental health admission wards’

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According to recent news items in the national press, acute mental health admission wards are not healthy places to be. My immediate response was ‘no kidding’ and I’m sure many of you will know what I mean.

In common with all wards, a lot of the time mental health wards can be crowded, noisy and sometimes dangerous – anything but the safe havens of recovery they should be.

So I’ve been wondering what exactly they are for. I’ve spent a lot of time in acute environments and it’s probably true to say it’s where the majority of mental health nurses do their work. It’s where we learn our trade and gain experience. And what experience it is.

I guess the theory behind these wards is that they are somewhere safe for very unwell people to be placed in order to be assessed and hopefully treated until the acute phase of their difficulties is over.

They can then be passed on to other parts of the service where work can continue. In an ideal world they are also therapeutic environments where people are not just medicated but able to access other helpful interventions. No, that wasn’t a joke. It really is, and should be, a best-case scenario. But, as we know, the reality is often very different.

Whoever thought it was a great idea to put lots of distressed people with different problems and needs into close proximity, with only a few nurses for company, was not thinking clearly. It was an experiment that may have sounded great in theory but was never going to work in practice.

Picture the scene – you are trying to support someone who is talking about ending their life. Meanwhile, next to them is a man who believes he can fly and is trying to leave the ward by a window to put this to the test. Someone else is taking their clothes off in the corner, having not slept for days. You should have another nurse with you but they are off sick with stress-related issues.

Welcome to another day on your regular acute ward. Unfortunately, we nurses have to work with the realities of the situations we find ourselves in. We do the best we can under the circumstances, trying to make the environment as therapeutic as possible, trying to do our best for those in our care.

But it shouldn’t stop there. Just because these wards are under-resourced and overstretched doesn’t mean this is how it will always be. Just the fact they are newsworthy could mean things are beginning to change. And in the meantime, we can carry on working in these extreme circumstances by remembering that if we can cope with this, we can move mountains.

Alison Gadsby is a mental health nurse in Cambridge

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