Saturday, 10 November 2012

who stands to benefit most from mixed gender psychiatric wards?

As a woman I've been a psychiatric inpatient on 3 occasions, most recently in 2002 in Lomond Ward, Stratheden Hospital, Cupar.  Where I had to sleep in a female dormitory that was overlooked by male patients in single rooms.  Having been put under a 72hr 'section' that meant I had to take the psychiatric drugs whether I wanted to or not.  And this was 'explained' to me by a psychiatric male nurse as I remember.

Being incapacitated by an anti-psychotic, being locked in and being in such close proximity to mentally ill male patients who I didn't know was very scary.  And having to depend on psychiatric nurses to keep me safe from harm, the very people who were forcibly treating me, and who I had prior experience of, in terms of having been forcibly treated in the past by psychiatric nurses.  Although the hospital back in 1978/84 had separate sleeping areas for female and male patients.

I have often considered the question of mixed gender psychiatric wards and their benefits, and have come to the conclusion that they are of the most benefit to psychiatric nurses.  In that having female patients mixed in with the men makes it easier to deal with the men.  And so makes the nurses' jobs easier.  It's been my contention for some years now that where I live the psychiatric inpatient care is staff centred and very little to do with the needs of patients or carers.

More recently the staff in the Lomond acute psychiatric ward near me got a much bigger staff room, where they sit in, overlooking the ward car park and from where they cannot see the ward rooms or patients if the door is shut.  Which often happened recently when I visited.  In fact I often had to knock on the door to speak to a nurse and on one occasion I even got the door slammed in my face, by a male nurse.  To which I made a complaint, along with many others.

So the nurses are the main beneficiaries of mixed gender psychiatric wards, followed by the male patients who I think will like to have female patients around, at mealtimes and in the lounge areas.  It follows then that the female patients are the ones who are least benefited by mixed wards.  Although some women might be OK about it, I definitely wasn't.  Especially since there are all sorts of reasons for patients being in acute wards eg substance misuse issues along with offending behaviour.  

In March when I was a daily visitor of the mixed gender acute psychiatric Lomond Ward, there was one male patient who spoke to me regularly and said he was waiting to go to court on an assault charge.  He was a large man with a scar on his face who tended to have the run of the ward.  By this I mean that he would get to use the phone in the staff room, was very familiar with female patients, often walking right down the ward corridor to the female dormitory.  And on one occasion when I was waiting around I saw him go down there and heard a female patient call out, no nurses to be seen.

When a nurse appeared I told her about the incident.  Not sure if anything was done about it.  I raised many complaints in the months of February and March this year, and haven't had satisfactory responses to all of them.  They still seem to be under investigation.  I think that psychiatric system complaints are not seen as important as other medical complaints.  As if the mental illness label means that psychiatric services are not accountable, can do as they like and justify it on the basis of mental illness, or difficult and demanding carers or family members

I want to see female patients in my local acute psychiatric ward at the very least having separate sleeping accommodation, even better if they could all have single rooms with ensuite facilities.  The women need to be kept safe and treated with respect.  This can only benefit everyone but most especially the women who may be mothers or grandmothers, sisters and daughters.  To this end I came up with a redesign of the Lomond Ward floor plan layout and sent it to staff.  This was weeks ago and I've had no response from management.

As a mother and grandmother I will continue to fight for improved psychiatric inpatient services so that the patients, carers and family members benefit.  Things really do need to improve for the next generation so that psychiatric services are truly person centred, involve shared decision-making and where mutual partnerships are created and sustained, as stated in the new Mental Health Strategy for Scotland.

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