Monday, 25 August 2014

"keeping it in the family": the issues that can arise when family members work in the same psychiatric settings

I believe there can be problems with family members working in the same psychiatric setting as nurses or managers (or doctors although that is likely very rare) eg father and son, mother and daughter, husband and wife etc.  

Because if a patient or carer raises concerns or a complaint about the unprofessional behaviour of a nurse or manager then this can impact on future care and treatment of the person.  Especially if a culture of intimidation and abuse already exists in a psychiatric hospital.  

For example.  If a nurse in an acute ward was involved with an incident of restraint on a patient which resulted in the patient being injured and transferred to the locked ward where his wife worked as a nurse, then the treatment of that patient and their carer might be compromised.  

I suppose it is understandable that a person will want to protect their family member.  I know what that is like.  However, in my opinion, there is no justification for dehumanising treatment and using force, for bullying mothers and carers, for denying basic human rights to psychiatric patients, for using locked seclusion rooms with no toilets or drinking water. 

Clinical managers in psychiatric settings where there is a history of family members working as nurses or other professionals have to be extra vigilant to ensure that complaints about practice are investigated independently and thoroughly.  It also should apply where clinical managers themselves have family members working in the same medical discipline and geographic area.  

I believe that comprehensive feedback processes and procedures will help with transparency so that all patients and carers can speak openly and truthfully about what their inpatient treatment was like without fear of repercussions.  Like customer feedback in other settings.  

The Patient Opinion website can help with this, in my experience.  Although it's only a start.  All health boards should have their own feedback systems and complaints processes that make it easy for people to give positive and negative feedback on their experiences of NHS services.

This is particularly important in psychiatric and mental health services where people can be compelled and coerced to take treatment, against their will, under law.  Where phrases like "non-compliant" and "without capacity" can be used to justify the use of coercion and the denial of a person's wishes, even if written previously in an Advance Statement which is not a legal document.

Independent Advocacy is another important safeguard under the Mental Health Act which unfortunately, I think, has lost its power and is a postcode lottery, in terms of whether a person can access good quality advocacy when necessary or can only get a tokenistic service, 9-5, Mon-Fri, with workers on low wages, managed by a service provider, paid for by statutory monies.

Another safeguard is the Mental Health Tribunal but in my experience this has been weighted in favour of professionals and is rarely won by patients and their advocates.  To win a case requires a good solicitor, supportive carer and an MHO who is on the side of the patient.  The latter is also rare, in my experience.

However despite the MH Act appearing to be more of a tool for the professionals rather than a protection for the people labelled with "mental disorder", and respect for their carers, I will continue to speak out and have a voice, to bring about balance, for the sake of justice.

"There will be justice ... when those who are not injured are as outraged as those who areThucydides

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