By Integrated Care Journal-
Mental health services that focused the most on applying the principles of least restriction were more successful in empowering their patients and staff to cope with the extra restrictions imposed during the Covid-19 pandemic, the Care Quality Commission (CQC) has found.
The CQC Monitoring of the Mental Health Act in 2019/20 report highlights that good services put emphasis on care planning to involve patients, as well as co-production with patients to improve the ward environment. However, with fewer beds and limited community support delivered through remote contact, CQC also highlighted that demand remained unmet during the first national lockdown.
Dr Kevin Cleary, CQC’s Deputy Chief Inspector of Hospitals and lead for mental health, said: “For the most part we have found that services have coped well, with some showing exemplary practice in the co-production of care with patients. Staff have also shown exceptional resilience by continuing to provide care, particularly in those services that have tragically lost patients or staff to Covid-19. ”
CQC has a statutory duty to monitor and report on how services apply the Mental Health Act 1983 (MHA) to detain and treat people who have a mental illness and need protection for their own health or safety, or the safety of other people.
CQC’s Monitoring the Mental Health Act in 2019/20 report places specific focus on the impact that Covid-19 has had on detained patients and on the services that treat them and sets out actions needed to support people subject to detention under the MHA.
The report concludes:
- It is vital that discharge planning is carried out in co-production with patients and their families/support networks in order to ensure better outcomes
- Patients must be involved in decisions about their care, including infection control, and where this is done the negative impact of restrictions on detained patients during a pandemic can be limited
- Carrying out modernisation of the physical estate would help with infection control measures
- Services should recognise the significant impact restrictions on leave of absence and activity can have on detained patients and ensure these are lifted as quickly and as safely as possible to avoid very damaging ‘closed cultures’ from emerging
- The relaxation of rules around the use of personal technology, such as mobile phones, should continue in future, and services should prioritise linked issues such as WIFI connectivity in future estates development
- Advocacy should move to be offered on an opt-out basis in future
- Careful evaluation of use of remote technology for care, treatment and contact purposes needs to be undertaken should aspects of them continue after the pandemic.
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