What young people told us
The experience the young people reported directly to us was varied, but overall positive.
Privacy and dignity
With regard to facilities only one person said he was not in a single room. He explained that he had been in a single room initially, but was then moved to a dorm, and speaking about this he said "it doesn't bother me". Four of the young people seen did say that although they had a single room they did not feel they had privacy in their bedroom, and these negative responses appeared to relate to their observation status. Two young people also said they were not aware of having a safe place to keep their personal belongings, other than in the ward office. Two of the young people also said that they did not feel they had privacy in the toilet/bathroom areas. One commented specifically that staff only knocked once before entering the bathroom -"they do it so quickly you don't have a chance to say I'm in"
The majority of the young people interviewed said that they could make hot drinks or snacks when they wanted to, however six said that they could not. A further two said they could only make hot drinks. Not being able to make snacks appeared to be linked directly to eating plans which were in place. Thirteen people said they could make a private phone call when they wanted to. Of the three who said they couldn't, in one case this was because they were subject to constant observation, in another case this related to the location of the pay phone in the corridor, while the other young person did not comment further. All the young people we spoke to felt though that they were able to keep in touch with friends and family, and vice versa, but three felt that there wasn't enough privacy when they had visitors. Two stated that the only private option was to meet visitors in their bedroom.
When asked if there was anything they would want to change about the way things are organised in the unit nine said no, and seven said yes. In the latter group comments related to having increased access to bedrooms. Some young people could only access their rooms for two hours in the afternoon; others wanted the opportunity to have a bath rather than a shower.Broader comments related to the need for change in relation to "the general way patients are treated in a very restricted regime".
When asked about feeling safe in the unit thirteen said they felt safe while three said they did not. Of the three, two said they had felt threatened on the ward. Worryingly they didn't feel able to talk to anyone about their safety concerns.One explained that he would rather be with people his own age, even if this meant being further away from family and friends.
Participation
The new mental health legislation is underpinned by a number of principles and emphasises the importance of individual people participating as fully as possible in any decisions made about their care and treatment. The principles also say that people should be provided with information to help make participation meaningful.
We asked the young people questions about their involvement in care planning generally and in decisions about their care and treatment. Eight of them had seen their care plans and six felt they were involved meaningfully in discussions about their care and treatment. Eight young people had not seen a care plan, and two of this group felt they had not been involved in discussions about their care and treatment. Although the other six had also not had sight of their care plan, they all commented that they had been involved to varying degrees in discussions about their care and treatment.
"I get involved in ward meetings but there are six people around me sometimes so I just nod my head".
Fourteen out of the sixteen young people said that they felt "they were listened to".
All sixteen young people we spoke to confirmed that they were receiving medication for their mental illness.Twelve confirmed that the reasons for prescribing this medication had been discussed with them and they had agreed to take the medication accordingly.The other four did not recall anyone explaining the reasons why medication had been prescribed, but, they all confirmed that they had agreed to take the medication.Six young people confirmed that they knew what the plans were for their future care however, one of the respondents described his future care plan as "to sign myself out".The others did not know of future care plans.
Contact with staff
Experiences of accessing staff in the units varied. Some young people told us that they had weekly key worker sessions, others said they could access their key worker "any time"and others whenever their named nurse was on shift.Twelve out of the sixteen young people clearly stated that staff treated them with respect.Two others described this as "variable" "some are helpful, some are very punitive".One young person commented that she did not think staff treated her with respect at all- "I don't think any of them like me".One of the young people interviewed had been in a residential care setting and subject to supervision requirements prior to admission. This young person described the transfer to a specialist young person's inpatient unit as a very positive move.
Contact with family
We asked young people whether they were able to keep in touch with families, and they all said they could. Visiting policies within the specialist units varied. Most units have core visiting times, but offer flexibility to families if required and actively encourage family contact and involvement. At the time of the visit one unit was offering rather restricted visiting times, however following discussions with us this policy is now under review. Units report that financial support is available for families on benefits to visit, especially if they have to travel a distance and one unit does have overnight facilities for parents visiting from distant parts of the catchment area. Involvement of families in family therapy is provided for the majority of services. Where this is not clinically indicated, family support is provided by nursing and medical staff. This can take the form of face to face meetings and telephone contact, especially when young people are spending time at home.
