Older people's functional mental health wards in hospitals - new report

A new report from the Mental Welfare Commission shows mixed findings in Scotland’s hospital wards for older people with mental illness.

The Commission visited all 23 NHS wards for older people with ‘functional mental illness’, which relates to conditions other than dementia. 

The environment in almost all of the wards had improved since the last visit in 2015, and were often in new, purpose-built facilities.

However, the decision to move patients from general adult mental health community and inpatient services  to older age services was often made without involving the patient, and the process for making that decision was often not clear or consistent.

In wards that had invested in therapeutic and recreational activities, patients told the Commission about the positive difference this made to their lives.

Only seven of the 23 wards reported regular input from psychology.

Pressure on beds elsewhere meant that wards were increasingly accepting patients with a diagnosis of dementia only. While it is appropriate that these wards can and do treat some patients who have both functional mental illness and dementia, the Commission is clear that mixing  patients who are solely diagnosed with dementia with those who do not have that diagnosis is challenging, and does not meet the needs of either group.

The Commission interviewed almost 100 patients and 23 relatives/carers, reviewing a further 50 patient files. 

Alison Thomson, interim chief executive at the Mental Welfare Commission, said: 

“It was great to see significant improvements in the physical environment of most of the wards. And the positive impact of therapeutic activity to patients’ health and wellbeing where it was offered was also absolutely clear. It can transform a person’s self-worth, and should be available on every ward.
“A major part of mental health care is psychological therapies, which help people make positive changes in their lives. We were disappointed to find that only seven of the 23 wards reported regular input from psychology, and we are asking for this to be reviewed and increased.
“Our recommendations for change include a call that all wards ensure that people with dementia are not admitted inappropriately to these wards just because there is pressure on beds elsewhere. 
“We are also asking for clear protocols for patients moving from adult to old age mental health community and inpatient services, with an assurance that decisions are not based on arbitrary age limits."

Relatives/carers told the Commission of the impact of the illness on them and the rest of the family.