Spike in assaults on staff in psychiatric hospitals as covid 'frustration' boils over

By Jonathan Humphries

While covid has battered our emergency hospitals, the effects of the pandemic have also had a profound effect on the mental health of Merseyside.

For staff working in the secure psychiatric hospitals in the region, staffing pressures, the increased anxiety and worsening health of patients and the reduction in activities and family visits have created a worrying situation.

Mersey Care NHS Foundation Trust, which runs most of the city's mental health facilities including Ashworth, Clock View and the recently opened Rowan View secure hospitals, has been grappling with a spike in assaults by patients on staff.

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According to a recent patient safety report to the Mersey Care board, the trust recorded a 12% increase in assaults on staff during the past year (August 2020 – August 2021) in comparison to the same period in 2019.

More worryingly, the figures included a 15% increase in assaults on staff causing harm, and the use of restraint by staff on patients had also increased.

According to the report: "A review of the increased patient aggression on staff and the Trust wide approach being adopted to support this has been undertaken, this review also considered the Trust being one of the frequent outliers from the staff survey results in relation to violence and aggression against staff, and the impact on our Black and Minority Ethnic (BAME) staff as a result of increased incidents of hate crime.

"Again, during this reporting period there has been a continued increase of violence and aggression incidents across the Trust with particular escalations in both Local and Secure divisions."

The trust said the review had identified covid related infection control measures as one of the drivers of the problem.

According to the report: "A review of the precipitating factors leading to the upward trend in the use of restrictive practices and assaults on staff since March 2021 has identified the ongoing impact of the COVID-19 pandemic and its toll on staff and services as efforts to reduce transmission persist.

"I.e. reduction in Multi Disciplinary Team (MDT) visibility and input, reduction in meaningful off ward activities, suspended Section 17 leave, suspended family visits leading to increased anxiety and frustration within the service user group appears to have contributed to the increase in incidents of assaults on staff, physical restraint, seclusion and Long Term Segregation across services."

A spokesman for Mersey Care NHS Foundation Trust said: “We are an organisation that regards all assaults against our staff as unacceptable and we will continue to support our staff, who often work in difficult and challenging circumstances.

“Mersey Care treats the safety of its patients, staff, and visitors very seriously and when these incidents happen there are rigorous procedures in place, together with a review of the events so we may learn from them.

“We are aware of the recent increases in assaults on staff and assaults causing harm and have reviewed the reasons and precipitating factors which contributed to this, including the impact of the COVID-19 pandemic and the clinical acuity of some of our patients.

"We have developed a plan to reduce the trends, based on our Trust Reducing Restrictive Practice Guide.

"Mersey Care remains incredibly grateful for the ongoing commitment of all of our staff and remain committed to their safety and wellbeing. There is a concerted effort to ensure staff feel supported whilst we work through the causes for the increase in aggression and this takes a number forms - bespoke training, staff debriefs after each incident, increased clinical supervision, incident analysis and continued working with the police to ensure timely notification of incidents that warrant police investigation.

“We also offer various support services including Occupational Health and Health & Wellbeing services to mitigate the impact of the challenging issues our staff may encounter."

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