Mental health unit restrictions made me sicker, says Fishguard patient

Francesca Murphy was still in her school uniform when she was admitted to an adult mental health ward.

She was 18 years old, still in school, and extremely scared.

Mind Cymru said it was concerned about staff shortages, care planning and the use of restraints in mental health inpatient units across Wales.

The Welsh Government said £2 million had been invested in the improvements.

Ms Murphy, now 27, said her life changed dramatically after a boating accident in 2014.

She was trapped under her boat with a rope wrapped around her ankles after capsizing.

She was rescued and physically recovered, but this led to a rapid decline in her mental health, which led to self-harm and suicide attempts.

She was admitted to the Child and Adolescent Inpatient Unit, but was released back into the community the day before her 18th birthday.

Since then, she has volunteered and spent time in various mental health inpatient units across Wales and England under the Division.

Mrs Murphy, from Fishguard, Pembrokeshire, said: “I’m what you call a revolving door patient.”

She would go missing before being picked up by police and temporarily hospitalized, before being released two days later.

“The circle goes around,” she added.

The longest she was in the hospital was between six and seven months.

She said she would not be here today without the support she received from her psychiatrist.

However, she also recounted some traumatic experiences in the hospital, where she was physically and medicated.

She held her face down at least twice.

Restraint or restrictive practices should always be a last resort, and attempts should be made to defuse volatile situations in advance.

“[It was] Terrible. I had three boys and one girl hold my four limbs and then inject me and calm me down before talking to me to escalate the situation,” she said.

“I remember one time, clearly I heard, ‘Let’s get her in the room.’

“I was still trying hard to get over the memories of the sailing incident and when something happened around my ankle, it would trigger everything that had happened.

“It just makes me sicker.”

Ms Murphy agreed that mental health inpatient units needed improvements.

Consistency of care and clear communication are critical, she said.

“If you’re going to do something, do it, don’t say you’re going to put something in and then follow through.

“I was lucky to have an incredible therapist who looked at me holistically, and they worked with my family … a lot of professionals wouldn’t talk to them,” she said.

She also said there is a lack of eating disorder training in general psychiatric units.

Ms Murphy has now been released from mental health services and is back on the water, working two jobs, coaching yachts.

“I want to speak for the people who are no longer represented here.”

She contributed to that Mind Cymru’s new report It focuses on mental health residential wards in Wales.

Concerns were raised about staff shortages, lack of data and general care and safety.

The charity found that 13 out of 18 hospitals had a negative impact on patients due to staff shortages in 2022-23.

It also said more comprehensive data collection is needed to provide a more complete picture of inpatient care and restraint, particularly around race and other protective characteristics, to address any disparities and discrimination.

It outlined several areas for improvement, including the need to bring restrictive practice rules in line with the law in England.

Across the border, the Mental Health Units (Use of Force) Act 2018 – known as Seni’s Law – aims to protect patients from the use of disproportionate and inappropriate force.

In Wales, guidance is not statutory.

Simon Jones of Mind Cymru said the guidance in Wales should be similar but a legal requirement.

“We want to see that in Wales as the statutory element adds legal protection and the data collected is more transparent so we’re really clear about what’s going on,” he added.

The Welsh Government said improving the safety and quality of mental health was a priority.

It says it will reflect a £2m investment in improving services, which includes a mental health patient safety programme.

“We recently consulted on our draft Mental Health and Wellbeing Strategy, which has been developed in collaboration with a range of partners, including service users and carers, setting out our vision for improvements over the next 10 years,” it added.

If you, or someone you know, has been affected by mental health problems or self-harm, help and support is available BBC Action Line