London's mental health hospitals must be made safer places to work, says The King's Fund report

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Tackling safety in some of London's mental health hospitals, as well as problems of excessive workloads and poor housing opportunities, are key to easing staff shortages that continue to be at crisis levels, says a new report, from The King's Fund.

Mental health nurses responding to a 'reality check' survey spoke of safety worries caused by violence, harassment and drug dealing on acute mental health wards in the capital. Stress, overburdening workloads and a lack of affordable housing were also contributing to recruitment and retention difficulties.

London's Mental Health Workforce, which comes six years after the 1997 The King's Fund Inquiry into London's mental health, highlights a crisis in recruitment and retention of mental health professionals across all disciplines. It warns that high turnover rates among mental health nurses and an over-dependence on agency staff continue to threaten the government's plans for service reform.

Vacancy rates among mental health nurses in London range between 13 and 23 per cent, compared with an average of 6.1 per cent in the general acute sector in London. Vacancy rates for occupational therapists working in mental health hospitals in the capital are up to 57 per cent, compared with an average of 8.3 per cent in the general acute sector.

Report author Pippa Gough said:

'Acute mental health wards can be challenging, stressful and dangerous working environments. Nurses are increasingly vulnerable to violent and intimidating behaviour, and patients are also losing out when ward environments are unsafe.'

The report highlights positive developments in tackling high turnover and vacancy rates and improving continuity of care, such as the nurse rotation scheme which aims to increase the average length of time that newly-qualified mental health nurses stay in trusts.

London's Mental Health Workforce calls for clearer policies about acceptable behaviour by patients and visitors on wards, together with the authority to take action where these are violated; clear drug and alcohol policies which are backed up with mechanisms to support staff when these policies are violated; and better training and education practices to prepare mental health workers for the challenging demands placed upon them.

Notes to editors

London's Mental Health Workforce: A review of recent developments, by Leena Genkeer, Pippa Gough and Belinda Finalyson, is available free from the King's Fund on 020 7307 2591 or on our online bookshop. The paper looks primarily at the workforce involved in adult mental health services, rather than services for children, adolescents or older people.

The report is one of a series being produced in 2003 as part of the King's Fund Mental Health Inquiry. The Inquiry aims to assess whether London mental health and mental health services have improved over the last five years. In 1997 the King's Fund produced a report entitled London's Mental Health, describing services in inner London 'that cannot be sustained'. The current Inquiry asks what, if anything, has changed since then, as well as tackling some new questions. The findings will be published later this year.

For review copies or interviews with the authors, please contact Daniel Reynolds on 020 7307 2581 or 07831 554927.

The Sainsbury Centre for Mental Health today publishes A Mental Health Workforce for the Future: A planner's guide, which says staff shortages in mental health need to be solved in radical new ways if they are to offer the service users need. The guide is available from the SCMH on 020 7827 8352, price £15 plus 10 per cent p&p.