One of the most commonly raised issues on the wards since the beginning of the year has been the old favourite topic of ‘activities’. Patients spoke positively about their increased access to art and music therapy – several times people showed us art-work, gave the groups poems to read, or played us music they had made, something we’re keen to encourage. We want groups to be accessible to everybody and if people want to express their views in ways other than just attending a meeting in the traditional way, then we’re all ears. People also spoke about how beneficial they find being able to do physical exercise and how much they valued access to the gym as well as the exercise equipment available on some wards. Some people wondered if a running group could be started, many people seem to find this form of exercise very therapeutic. That other old chestnut issue – smoking – was also brought up in groups often. Patients had noticed the variations in the way the policy is implemented in different wards and groups discussed whether or not this was justifiable. Many patients felt that allowing smoking in courtyards/gardens meant that people were less likely to smoke within the wards. Nevertheless, we learned that a further change to the smoking policy will come into force in August, when the rule about no smoking within 15 metres of hospital buildings will be enforced. This would put an end to smoking in courtyards. The other issue that arose frequently was around the use of force, restraint and seclusion. Patients spoke about their experiences of compulsion and of feeling that their safety, privacy and dignity had been affected. At times, they often found it difficult to balance the use of force with their wish to be treated kindly and compassionately. There was a widespread feeling that at times, wards operated according to a punishment model and that there exists a power dynamic between patients and staff and that in any such situation there is a danger that “power corrupts”. On the flip side, other patients spoke about how they had been “saved” many times by being detained. We also heard from people who had spent time in the hospital’s High Dependency Units: this can be a very difficult experience for patients. We also heard that using this type of seclusion for hopefully short periods of time can actually reduce the use of restraints. It seems like there are no easy answers in mental health care.
