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Acute Problems: A Survey of the Quality of Care in Acute Psychiatric Wards. By Sainsbury Centre for Mental Health. London: The Sainsbury Centre for Mental Health. 1998. 56 pp.

Acute Problems: A Survey of the Quality of Care in Acute Psychiatric Wards. By Sainsbury Centre... Book reviews Acute Problems: A Survey of the Quality for mental health services should be improved, to allow more staff to be employed to deliver the sort of Care in Acute Psychiatric Wards. By Sainsbury Centre for Mental Health. of care that they advocate. After all, the present staff are not sitting on their hands: in my view London: The Sainsbury Centre for Mental Health. 1998. 56 pp. there are not enough of them in many areas. Having exhaustively documented the deficiencies In this second, more Intensive report on acute in- of the buildings in which acute care takes place, patient care from the Sainsbury Centre, 215 they rightly conclude that commissioners and patients on nine different acute wards were providers should take steps to improve the studied soon after admission, during admission hospital environment. Addressing providers, and after discharge. The picture that emerges is they urge that a range of therapeutic activities extremely disquieting, although unlikely to sur should be made available, and that recreational activities should be "considered as therapy", and prise those who work on similar wards. The authors find that there is little evidence of made available throughout weekdays and at individualised treatment plans while on the weekends. This, they assert bravely, will make in-patient care "optimally effective". ward, and that patients often feel unsafe and spend much time doing nothing. They note the The authors describe alternatives to hospital admission as "lamps in a dark landscape", and absence of the multi-disciplinary team, and make recommendations for implementing "a record that in-patient care is often confined to range of crisis services". It is certainly correct interviews with psychiatrists and care from nurses. Care from occupational therapists, so that much pressure could be taken off acute cial workers and psychologists is unusual, and units if alternative facilities were available for often late in coming. Despite this, the patients people who do not need acute care, but it is improve, with symptoms on the Brief Psychiatric unlikely that all the patients whose histories are Rating Scale (Overall & Gorham, 1962) falling given in detail could be cared for in such facilities - unless, of course, they were acute from an average 12.7 on admission, to only 6.4 units that happened to be housed in non- on discharge. The authors appear bemused by this finding, saying it is "against the odds", but it institutional settings. Overall, this is a generally should cause them no surprise: if patients are helpful report both for the mentally ill and for admitted at a time of acute crisis, and most of those who care for them, and it is to be hoped them receive chemotherapy, a reduction of this that useful action will flow from it. magnitude is to be expected. They state that "nearly a fifth of patients receive no medication whatsoevef (emphasis added); but this should Reference not surprise them either, as on an earlier page OVERALL. J. E. & GORHAM.D. R. (1962) The Brief Psychiatric Rating Scale. Psychological Reports, 10. 799-812. they state that 15% had no diagnosis or that of personality disorder, while 10% were social or respite care admissions. They make no com David Goldberg, Director of Research & ments on the fact that many more patients Development, King's College, London and receive major tranquillisers than receive diag Institute of Psychiatry, De Crespigni) Park, noses of psychotic illness, and that one-fifth of Denmark Hill, London SES 8AF the patients in one unit had been in seclusion, while staff in five of the nine wards managed perfectly well without seclusion rooms. The authors draw 10 major conclusions from their Mount Misery. By Samuel Shem. survey, when taken together with other pub London: Black Swann. 1999. 570pp. £7.99(pb), ISBN 0-552-99813-3. lished work on acute care. Addressing them selves to the Department of Health and commissioners, they state that "patient-centred Samuel Shem's novel charts the first year of an care should be the fundamental principle under American young doctor in the fictional psychia pinning . . . acute care"; and this seems likely to tric hospital Mount Misery. Dr Roy Basch, the be adopted by the Department of Health, and to hero, chose a psychiatric career after becoming form yet another exhortation to the providers of disillusioned with medicine. It is the sequel of care. The authors do not suggest that resources The House of God (Shem, 1985), his first novel. Psychiatric Bulletin (1999), 23, 637-638 http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Psychiatric Bulletin Unpaywall

Acute Problems: A Survey of the Quality of Care in Acute Psychiatric Wards. By Sainsbury Centre for Mental Health. London: The Sainsbury Centre for Mental Health. 1998. 56 pp.

Psychiatric BulletinOct 1, 1999

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Unpaywall
ISSN
0955-6036
DOI
10.1192/pb.23.10.637
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Abstract

Book reviews Acute Problems: A Survey of the Quality for mental health services should be improved, to allow more staff to be employed to deliver the sort of Care in Acute Psychiatric Wards. By Sainsbury Centre for Mental Health. of care that they advocate. After all, the present staff are not sitting on their hands: in my view London: The Sainsbury Centre for Mental Health. 1998. 56 pp. there are not enough of them in many areas. Having exhaustively documented the deficiencies In this second, more Intensive report on acute in- of the buildings in which acute care takes place, patient care from the Sainsbury Centre, 215 they rightly conclude that commissioners and patients on nine different acute wards were providers should take steps to improve the studied soon after admission, during admission hospital environment. Addressing providers, and after discharge. The picture that emerges is they urge that a range of therapeutic activities extremely disquieting, although unlikely to sur should be made available, and that recreational activities should be "considered as therapy", and prise those who work on similar wards. The authors find that there is little evidence of made available throughout weekdays and at individualised treatment plans while on the weekends. This, they assert bravely, will make in-patient care "optimally effective". ward, and that patients often feel unsafe and spend much time doing nothing. They note the The authors describe alternatives to hospital admission as "lamps in a dark landscape", and absence of the multi-disciplinary team, and make recommendations for implementing "a record that in-patient care is often confined to range of crisis services". It is certainly correct interviews with psychiatrists and care from nurses. Care from occupational therapists, so that much pressure could be taken off acute cial workers and psychologists is unusual, and units if alternative facilities were available for often late in coming. Despite this, the patients people who do not need acute care, but it is improve, with symptoms on the Brief Psychiatric unlikely that all the patients whose histories are Rating Scale (Overall & Gorham, 1962) falling given in detail could be cared for in such facilities - unless, of course, they were acute from an average 12.7 on admission, to only 6.4 units that happened to be housed in non- on discharge. The authors appear bemused by this finding, saying it is "against the odds", but it institutional settings. Overall, this is a generally should cause them no surprise: if patients are helpful report both for the mentally ill and for admitted at a time of acute crisis, and most of those who care for them, and it is to be hoped them receive chemotherapy, a reduction of this that useful action will flow from it. magnitude is to be expected. They state that "nearly a fifth of patients receive no medication whatsoevef (emphasis added); but this should Reference not surprise them either, as on an earlier page OVERALL. J. E. & GORHAM.D. R. (1962) The Brief Psychiatric Rating Scale. Psychological Reports, 10. 799-812. they state that 15% had no diagnosis or that of personality disorder, while 10% were social or respite care admissions. They make no com David Goldberg, Director of Research & ments on the fact that many more patients Development, King's College, London and receive major tranquillisers than receive diag Institute of Psychiatry, De Crespigni) Park, noses of psychotic illness, and that one-fifth of Denmark Hill, London SES 8AF the patients in one unit had been in seclusion, while staff in five of the nine wards managed perfectly well without seclusion rooms. The authors draw 10 major conclusions from their Mount Misery. By Samuel Shem. survey, when taken together with other pub London: Black Swann. 1999. 570pp. £7.99(pb), ISBN 0-552-99813-3. lished work on acute care. Addressing them selves to the Department of Health and commissioners, they state that "patient-centred Samuel Shem's novel charts the first year of an care should be the fundamental principle under American young doctor in the fictional psychia pinning . . . acute care"; and this seems likely to tric hospital Mount Misery. Dr Roy Basch, the be adopted by the Department of Health, and to hero, chose a psychiatric career after becoming form yet another exhortation to the providers of disillusioned with medicine. It is the sequel of care. The authors do not suggest that resources The House of God (Shem, 1985), his first novel. Psychiatric Bulletin (1999), 23, 637-638

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Psychiatric BulletinUnpaywall

Published: Oct 1, 1999

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