Chris Munt, mental health act manager at the Hertfordshire Partnership University NHS Foundation Trust, spent months gaining the confidence and trust of traumatized psychiatric patients who were initially too terrified to reveal their brutal abuse. They feared reprisal from hospital staff or assumed that, as patients, they simply would not be believed.
“It is very difficult for patients … to actually take that brave step of formally complaining,” Munt said. “The preoccupation for many patients is that they do not want to expose themselves to any risk of revenge.”
“How can hurting someone be helpful?”
But what Munt and University of Hertfordshire researcher Dr. Brian Littlechild, professor of social work, ultimately discovered—as revealed in painstaking interviews with 21 patients and two caregivers—was deeply troubling: over 750 incidents of coercion and violence by psychiatric staff.
Patients were physically and verbally abused, restrained, shoved and forcibly drugged. Staff ignored patients and even threatened to tamper with their records. Worse, there was evidence of a “toxic” coverup atmosphere in which staff protected each other against patient claims of abuse.
Eight patients said they had been pinned down by several staff members—a total of 37 times over several years—and suffered over 100 instances of severe verbal assault.
The study forms the first chapter of the new book Coercion and Violence in Mental Health Settings, and contains heartbreaking quotes from actual unnamed patients who took part in research.
They said:
- “If you found yourself in their way, they would just shove you … without asking you to move.”
- “Staff would surround me like a stray animal and get hold of me.”
- “People kept telling me to calm down, then I was on the floor with staff holding me down. I was so scared.”
- “Some staff seemed to enjoy confronting people, especially pinning them down.”
- “They forced her to the floor and injected her.”
And finally: “How can hurting someone be helpful?”
How indeed.
“We are collateral damage for a service that no one really cares about.”
“Violence towards patients, and deliberate and premeditated coercion,” Munt wrote, “does exist in the UK mental health system … more frequently than we would care to contemplate.”
Patients were also targeted with demeaning language, Munt said, noting that those “of a certain size or shape or orientation or gender” would be “actively humiliated on a regular basis, often with the same staff, using the same language in a very derogatory fashion.”
The researchers made several suggestions for improvements, including having a social worker present in each facility, holding unexpected visits from health authorities and requiring psychiatric facility staff to wear body cameras while at work, to document any patient abuse.
While the study has ignited a firestorm of concern in official British health circles, it remains to be seen whether anything constructive will be done.
“It is unacceptable that mental health patients report feeling this way,” a spokesman for the National Health Service said. “NHS England has co-produced national standards with a range of independent experts which sets out the culture of care expected across all mental health hospitals, including ensuring patients feel safe and are able to raise concerns.”
“Patient safety is paramount and any staff committing acts of violence or abuse should be removed permanently and face the full force of the law,” said one spokesperson from the Department of Health and Social Care. “These findings are disturbing, and we encourage any patients or families who suspect abuse to report it to the authorities.”
Patients, of course, are considerably less likely to believe that any positive changes will be forthcoming:
- “We are collateral damage for a service that no one really cares about. In a week from today, most people will have forgotten about it, unless they are unfortunate to find themselves as a patient.”
- “They will take it on the chin, promise that lessons will be learned, move on and repeat the same crimes in five years’ time.”
- “It’s not the first case of whistle-blowing and exposing brutal staff and uncaring services. I hope this is the one that will lead to change, but I’m not holding my breath.”
Munt is calling for a “radical root and branch transformation” of the whole system.
“A great deal of work must take place to foster and secure better interpersonal relations on the ward. The environment should reflect a place where staff look forward to coming to work, patients feel they can begin to feel better and carers and friends are welcome visitors,” Munt and Littlechild wrote.
We can only hope.
