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Acute in-patient psychiatry: how patients spend their time on acute psychiatric wards

South London and Maudsley NHS Trust, 4th Floor Ladywell Unit, Lewisham Hospital, Lewisham, London SE13 6LW, email: jonathan.radcliffe{at}slam.nhs.uk

Roger Smith, Consultant Clinical Psychologist

Lewisham Hospital

Declaration of interest

None.

This is one of a series of papers on acute in-patient services.

AIMS AND METHOD

We observed levels of social interaction and activity among in-patients on 16 acute psychiatric wards in 6 hospitals in a large mental health trust. Each ward was observed for 1 week and attendance at organised activities was audited over 3-week periods.

RESULTS

At any time during the day 84% of in-patients were socially disengaged and mainly inactive. On average only 4% of in-patients’ time was spent in an organised group activity, with many in-patients opting out altogether. Provision and take-up of group activity programmes varied widely between wards.

CLINICAL IMPLICATIONS

Provision of organised activity needs to be a higher priority in acute services, and there should be national and local standards for what should be provided. Concerted organisational strategies and assertive approaches by staff are needed to engage in-patients in group activity programmes.

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