Children's psychiatric ward report raises restraint concerns

Children's psychiatric ward report raises restraint concerns

A recent study has unveiled troubling practices surrounding the use of physical restraint and forced tube feeding at the Melville Unit, an inpatient mental health ward for 12 to 17-year-olds located at the Royal Hospital for Children and Young People in Edinburgh. This investigation was part of a series of visits to psychiatric wards prompted by allegations of mistreatment at Skye House in Glasgow, revealed by a BBC Scotland’s Disclosure program. NHS Lothian has acknowledged the concerns raised in the report and stated that steps are being taken to address the recommendations made to enhance care at the unit.

Conducted jointly by the healthcare watchdog and the Mental Welfare Commission (MWC), the inspection highlighted both positive aspects, such as high staffing levels and good practices, as well as areas for improvement at the Melville Unit. The visit to the 12-bed facility involved unannounced checks made during a week in May. The MWC emphasized the need for the judicious use of restraint as a last resort at the unit, particularly in cases of nasogastric feeding, stressing the importance of exhausting all alternatives before employing restraint.

Grace Vickers, a former patient at the Melville Unit, shared her harrowing experience of being subjected to forced tube feeding and restraint during her time there from the age of 16 to 22. She recounted the recurring nightmares and trauma resulting from witnessing and experiencing these distressing procedures. Grace’s story sheds light on the long-lasting impact such practices can have on individuals, with her now facing complex post-traumatic stress disorder as a consequence of her time at the unit. Despite some positive changes since her stay, the inspection report highlighted areas where improvements are still needed.

The report also revealed concerning figures, stating that out of 661 incidents reported at the unit over two years, 533 involved the use of restraint. Additionally, issues such as alleged overuse of restraint, lack of appropriate outdoor spaces, and insufficient activity options for patients were raised by inspectors. While praising the dedication of staff and their commitment to the well-being of the young people under their care, the MWC stressed the need for further improvements in care planning, parental involvement, and staff training. NHS Lothian has vowed to address the shortcomings identified in the report by implementing strategies to reduce the use of restraint, improve monitoring practices, and enhance overall care for patients at the Melville Unit

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