What is behind a new mental health abuse scandal?

The lack of trained staff and society’s view of people with mental distress are a toxic mix

An abuse scandal on an appalling scale is said to have erupted at a mental health facility in Manchester.

The BBC’s Panorama programme says it has evidence of severe malpractice after deploying a reporter as an undercover member of staff at the Edenfield medium-security institution.  It plans to broadcast a programme about Edenfield this week.

Well-placed sources told the Manchester Evening News last week that allegations include “serious abuse” of adult patients. Police are now investigating and Greater Manchester Mental Health trust has suspended up to 30 staff.

A similar expose in 2011 detailed the shocking way people with learning difficulties and challenging behaviour suffered physical and psychological abuse at the hands of staff at the Winterbourne View private hospital, in South Gloucestershire. It led to a national scandal and inquiry that was supposed to ensure that nothing similar could happen again.

Edenfield treats around 200 patients, most of which have been sectioned by a court and are classed as a potential danger to themselves and others. The BBC’s footage from there is said to be as harrowing and shocking as that taken at Winterbourne. 

It will almost certainly lead to outrage that health professionals could treat some of the most vulnerable people in society in such a terrible way. But mental health workers elsewhere in Britain have told Socialist Worker that what happened at Winterbourne, and now seemingly Edenfield is not simply the result of cruel and sadistic people in the workforce.

“People going to work in secure settings need to be extremely qualified and experienced,” one mental health practitioner told Socialist Worker on condition of anonymity. 

“Patient behaviour can at times be very challenging, and even violent. But too often I hear that secure wards and units are staffed by people with little experience, and sometimes not a single registered nurse on shift.

“That is a recipe for disaster. If you don’t have enough experienced and skilled staff on, there is nobody to ensure a proper culture of care or to help with patients that are particularly distressed. Even very good staff without qualifications and practice simply don’t have the weight to do this.”

The practitioner also says understaffed and underskilled wards—which are increasingly common—lead to health workers becoming overwhelmed and responding badly to challenges.

“People without the right skills and backup can easily become frustrated at their inability to deal with patients that challenge them. They can even stop noticing the way they react. This phenomenon is so well-known in healthcare that it has a name. It is called ‘institutionalisation’ and ‘burnout’.

“Mostly, when people start working in mental health, they do so because they care, and want to help people. But when they are dropped into situations they can’t deal with, and without any resources or experience to fall back on, that enthusiasm can fade and be replaced by its opposite.”

People who start angry about the conditions they work in, soon adapt to them and often rely on bad coping mechanisms to get them through their shift, says the practitioner.

“You can’t be furious about your work every day,” they continue. “So, when faced with multiple demands that are impossible to meet, people working in these settings often dehumanise their patients—either consciously, or unconsciously.

“They find a way of switching off from them emotionally, of detaching. Not looking your patients in the eye is a way of avoiding their distress, and their distress becoming your distress.

“Many find this is the only way they can survive the job. But the problem is that the same process of dehumanisation can lie behind terrible care and even patient abuse. That’s why we have to put the issue of safe staffing at the centre of patient care.”

And these factors interact with a general societal prejudice against people with mental distress. It is easier therefore to think they should be treated in a worse way than other patients.

Worsening conditions at work, poor pay and lack of fully qualified staff have already driven some of the most experienced health workers out of the job. 

The NHS in England is currently short of 6,000 mental health nurses, and years of below-inflation pay deals mean that number will only grow. 

The regulator, the Care Quality Commissioner, downgraded some of Greater Manchester Mental Health NHS Trust services to inadequate in April this year.

At the time, Lyndsey Marchant, Unison union’s regional organiser, told the Manchester World news website, “We have been raising concerns about the serious lack of staff in many of Greater Manchester Mental Health NHS Trust in-patient and community teams for some time.

“We have said this puts our members at risk of both physical harm and prolonged mental distress. It also means staff cannot provide a safe and timely service for our service users, so services are unsafe for them too.  We feel as though the trust’s unwillingness to address our concerns has contributed to this announcement from the CQC.”

The new care scandal at Edenfield is unlikely to be the last. To get the standard of care and compassion that we expect vulnerable people to be treated with, there has to be a change in the culture and practices in many mental health institutions.

But that can only happen when we have fully staffed and resourced wards that enable health workers to care in the same way they wanted to when they started in the job.

Full story here

Source: Socialist Worker, 25th September 2022

Published by CHARM Greater Manchester

CHARM, the Community for Holistic, Accessible, Rights Based Mental Health was launched by The Organic Recovery Learning Community in September 2020.

One thought on “What is behind a new mental health abuse scandal?

  1. My son with SMI has also suffered horrendous abuse by local psychologist the Chief exec threatened me
    to keep my mouth shut – he took son off CMHT abandoned him with no one, it must stop live in Herts


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