It is undeniable that overcrowding and stressful environments are linked to violence. This is especially true in psychiatric wards providing care to a heterogenous patient group including acutely unwell patients, patients detoxing from drugs of abuse and patients who are known to use hospital as their ‘secure base’ because of myriad social problems.
The physical environment of wards is the factor that the hospital management can modify, and it has to be active in doing so.
As such, in the immediate situation MAP expects:
- Management needs to acknowledge the problem, and commit adequate resources to address and reduce violence, and promote a hospital culture that values the importance of safety and security.
- MHM must have established policies, procedures and guidelines that inform staff on how to respond to violence and how to report it.
- MHM to issue a statement regarding the huge number of admissions and overcrowding in hospital. The considerable increase in the island’s population has placed a greater demand on service provision however there has not been a change in the number of hospital beds available to cater for this population boom.
- MHM should prioritise communication with doctors through the public health channels about the increase in rates of admissions, and clarify reasons for increased demands on acute and community services. A task force to address overcrowding should be immediately appointed.
- MHM must ensure that any incidents of violence are followed up, and MHM offers support to victims. Serious incident reports are to be forwarded to Dr Brigette Sultana for proceeding to court obo hospital and victim with querela.
- Immediately launch a repeat of the exercise to check barriers to discharge, and action solutions.
- Commit adequate resources to gate keeping which includes ensuring that the crisis service is manned by a multidisciplinary team that is equipped to provide a range of services to support unwell patients in the community without the need to resort to hospital admission.
- Security systems need to be installed and functional in healthcare facilities: electronic access control, video surveillance, wired panic alarm, and electronic incident reporting system.
MAP is committed to ensure safety and well being of its members. We are keen to collaborate with hospital management in order to improve working conditions for our members as well as providing high quality care to service users.