The nature and purpose of acute psychiatric wards: The tompkins acute ward study

Abstract

Background: Acute inpatient care in the UK is being subjected to increasing critical scrutiny, highlighting concerns about content and quality. There is an absence of clarity and consensus on what acute inpatient care is for, adding to difficulties in developing this service sector.

Aim: To define the function of acute psychiatric wards.

Methods: Interviews were conducted with multidisciplinary staff (13 Ward Managers, 14 F Grade nurses, 11 Occupational Therapists and 9 Consultant Psychiatrists), on rationales for admission, their care and treatment philosophy, and the roles of different professionals.

Results: Patients are admitted because they appear likely to harm themselves or others, and because they are suffering from a severe mental illness, and/or because they or their family/community require respite, and/or because they have insufficient support and supervision available to them in the community. The tasks of acute inpatient care are to keep patients safe, assess their problems, treat their mental illness, meet their basic care needs and provide physical healthcare. These tasks are completed via containment, 24-hour staff presence, treatment provision, and complex organisation and management.

Conclusions: Professional education, audit, research and the structuring of services all need to be oriented towards these tasks.

Declaration of interest: This study was funded by the Tompkins Foundation and the Department of Health Nursing Quality initiative.

Keywords:

• Acute mental illness
• risk assessment
• healthcare
• treatment
• assessment