Features

Animal hospital – the therapeutic use of pets

Recent guidelines have stated how the use of animals can improve the mental well-being of patients who have long-term conditions.

Recent guidelines have stated how the use of animals can improve the mental well-being of patients who have long-term conditions.


Goats in jumpers, dogs, snakes and a skunk have all featured on wards in a bid to improve 
mental well-being. Picture: Alamy

Ellie Walsh’s first attempt at using animals to improve the well-being of people with mental health problems came when she brought two guinea pigs into an acute inpatient ward in 2006.

‘They lived in the garden for quite a while in a proper hutch and the patients and staff all helped looked after them. They were effective in reducing anxiety among the patients and soothing them.’

Ms Walsh, a nurse and assistant director of acute and rehabilitation services for NAViGO Health and Social Care, a community interest company in Lincolnshire, has set up a partnership with the Grimsby Institute’s animal care department, who supply NAViGO regularly with animals for the wards. ‘We’ve had goats in jumpers. In fact, five goats were on the unit once. It was all about fun.’

50%

Reduction of medication among those undertaking animal-assisted therapy in one study

NHS organisations have to be careful about infection control, which until recently has made them edgy about having animals on site, says Ms Walsh. ‘Many places were wary. When we first talked about bringing in animals it nearly blew the minds of the infection control people. But they have realised the advantages provided infection control governance is followed. Now, it’s normal for us to have a pony here.’

General principles

Ms Walsh has written a policy for the use of animals in the hospital. It states that no animal will be allowed in without an owner/handler who is responsible for ensuring the animal is healthy. As general principles, routine vaccinations have to be up to date and animals have to stay out of kitchens. If a bite or scratch does occur there are clear instuctions about how it should be dealt with and dressed, and staff have to ensure that service users’ tetanus vaccinations are up to date.

For regular pets a named employee must be designated to manage the pet’s physical care – including flea control, worming, grooming, exercising, care of bedding and accommodation. And any claws have to be trimmed regularly.

Ms Walsh does not formalise her animal therapy sessions; instead service users have the option of feeding or looking after animals when they are on the wards, or simply stroking and patting them.

And of course, animals do not suit everyone. Ms Walsh’s guidance states that animal-assisted therapy is contraindicated if it is ‘unacceptably hazardous for service users who are immune-compromised, allergic, pregnant or accident prone.’  And, she adds: ‘You have to be mindful of people who don’t like animals.’

Overcoming fears

Cygnet Health Care, which provides mental health services in the independent sector, held a pet therapy day in December for three wards at its hospital in Derby. The animals – provided by animal-assisted therapy organisation Critterish Allsorts – included a snake, a skunk, a giant millipede and a tortoise. A Cygnet spokesperson said: ‘Nearly everyone overcame their fears, and held the huge boa constrictor.’

Plenty of research studies highlight benefits in mental health settings of animal-assisted therapy, although few studies are large scale. The authors of the State Hospital pet therapy guidance argue that it can be difficult to find large samples of patients in mental health setting who are willing or well enough to take part.

Psychiatric social worker David Lee published a one-year study in 1987 of the effects of animal-assisted therapy in forensic psychiatric hospital settings in the United States. He found a 50% reduction in medication among those who had received animal-assisted therapy compared to a control group which had not. On a ward with pets no suicide attempts were recorded, but there were eight attempts on a ward with no pets. Lower levels of violence were also recorded in the animal-assisted therapy group.

0

suicide attempts on a ward using pets, compared with eight who have no pets

A study co-authored by clinical specialist Pauline Hall in 2000 involved five nursing home patients who had been unable or unwilling to engage in conversations. Verbal and non-verbal behaviours were found to be more frequent during dog visits. An RCN survey of 751 nurses in 2016 showed that 90% of nurses believe that contact with animals can improve the health of patients with depression and other mental health problems.

'Adhere to principles'

RCN professional lead for infection prevention and control, Rose Gallagher, argues that infection risks in animal-assisted therapy are very low, provided certain general principles are adhered to.

Staff hand hygiene is important, and animals should not be allowed in if they are unwell, says Ms Gallagher.

She adds: ‘Specific consideration should be given if the patient is MRSA positive. The carriage of MRSA in animals such as cats and dogs is documented and represents normal family flora due to a shared household. In such circumstances, the advice of the infection control team should be sought.’

90%

of 751 nurses believe that contact with animals can improve patient health

She believes that hospitals should have formal policies to ensure the welfare of the animals, patients, staff and visitors.  Allowing pets into a healthcare setting can be risky if the owner is in pain – for example in a maternity setting – or the animal senses their owner’s distress, Ms Gallagher says. ‘Under such circumstances a local risk assessment should be undertaken and the patient offered accommodation such as a single room.’

Bright, a charity which supports mental health patients, set up a website in February to encourage service providers to give patients more opportunities for contact with animals and pets.

Bright executive director and mental health nurse Geoff Brennan says: ‘If someone is an inpatient they might be missing their dog or cat. Couldn’t they have an hour or two with their animal sometimes?

‘Opportunities for contact with animals should be seen as normal and part of the everyday process of helping people with mental health problems. For many people with or without mental health problems, their relationship with their animals is both powerful and beneficial, with a strong sense of mutual and unconditional love.’

Other animal enthusiasts such as Ms Walsh agree: ‘We don’t have a pet in every day, but if we could, we would.’

'Increase in social interaction'

Some of the UK’s most challenging patients are held in The State Hospital in Lanarkshire – also known as Carstairs Hospital – where animal therapy is considered an important part of rehabilitation.

Its garden and animal therapy centre includes pigs, sheep, a goat, turkeys, geese and chipmunks. Patients are offered training to look after them and can take a qualification in feeding animals.

The hospital's director of nursing Mark Richards says: ‘Of all the benefits we have observed the most important is the increase in social interaction. The animals provide a bridge that can be used to help develop the therapeutic relationship.’

The hospital has produced guidelines on using animals as therapy for mental health patients. It says that being with animals gets patients out into the open and gives them exercise. Patients feel calmer and cope better with aggressive feelings.

Working with animals who are aggressive or abused can sometimes be beneficial for service users because they recognise parallels with their own lives, and this leads to empathy and trust, the guidelines state.

There are pitfalls, however. The hospital once bought two rats from a pet shop without realising they were pregnant. After giving birth they defended their young and bit two people.

 

Benefits to staff as well as patients

Nurse Betty Carmack has published work on how nurses can use animal-assisted therapy. She argues that animals, including dogs and guinea pigs, improve staff well-being in addition to having a positive effect on patients.

Dr Carmack, professor of nursing at the University of San Francisco, said: ‘Because of the recognised therapeutic benefits of animals and pets to both patients and pet owners, bringing animals into a hospital unit also can be beneficial to nursing staff in reducing their perceived stress.’

The death of her own pet dachshund, Rocky, made her realise the significance the loss of a pet can have on mental well-being. She has spent much of her professional life examining how people cope with the deaths of their pets, and providing counselling to those who are grieving the loss of a beloved animal.

 

Further information

 

Christian Duffin is a freelance Journalist

This article is for subscribers only

Jobs