By John Tingle
Mental health care is a high government NHS priority. There is a real drive to rob this care area of its Cinderella image. Mental health care should not now be seen as the poor relation of acute physical care in terms of resource allocation as it has been seen in the past. However, a recent report by the Health and Social Care Regulator of England, the Care Quality Commission (CQC) seems to push this care area back into the Cinderella limelight again with the finding that sexual incidents appear commonplace on mental health wards in the NHS. The CQC is a very important health and social care regulator in England and it produces excellent reports on health care quality and patient safety. The organisation makes sure health, social care services provide people with safe, effective, compassionate, high-quality care, and they encourage care services to improve.
Sexual safety on mental health wards
The report by the CQC contains a 2017 analysis of reports on patient safety incidents that staff submitted through the NHS National Reporting and Learning System (NRLS). The CQC found that many reports described sexual safety incidents, including sexual assault and harassment. The findings in the report are shocking, sexual incidents appear to be commonplace on mental health wards.
The CQC analysed nearly 60,000 reports and found 1,120 sexual incidents involving patients, staff, visitors and others detailed in 919 reports. This was 1.6 % of all the reports.
Some reports contained multiple incidents. The CQC state that when analysing the descriptions of the incidents in the reports, more than a third could be categorised as sexual assault or sexual harassment of patients or staff:
“We found 29 reports where allegations of rape were made. Other common types of incidents included nakedness (including in contexts where this was clearly non-sexual) and exposure, and sexual words used as insults…CQC has followed up each of the alleged rapes with the trusts to ensure they have addressed the incidents appropriately. “(p8).
Patients (95% of all reports) mainly carried out the alleged incidents. Members of staff were also reported to have carried out incidents in 51 (5%) of the reports.
Communal areas were the main place for alleged sexual incidents, (416). One hundred and ninety-four incidents were alleged to have taken place in patients’ rooms or other private areas such as toilets and bathrooms. A key finding from the report is that people who use mental health inpatient services do not always feel that staff keep them safe from unwanted sexual behaviour. A change of culture is called for where health care staff take seriously patient allegations of sexual misconduct.
The report contains other findings as well and calls for more clear guidance of what constitutes good practice in promoting the sexual safety of mentally ill patients. Many staff do not have the skills to promote sexual safety or to respond appropriately to incidents.
The report is very clear and concise and raises fundamentally important patient safety issues.