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Hospital staff lack confidence and knowledge to care for people with mental health conditions, warns report

Hospital staff often lack the knowledge or confidence to care for people with mental health conditions appropriately, according a major new review.
Mental health

Hospital staff often lack the knowledge or confidence to care for people with mental health conditions appropriately, according a major new review.

Fewer than half of those who visit hospital with a physical condition, but also happen to have a mental health problem, receive good quality care, according to the latest report from the National Confidential Enquiry into Patient Outcome and Death (NCEPOD) .

The authors carried out detailed reviews of 552 cases from patients across England, Wales and Northern Ireland with a mental health condition who presented at NHS hospitals for a physical health condition.

Issues identified in the report included a lack of staff training, inadequate mental

Hospital staff often lack the knowledge or confidence to care for people with mental health conditions appropriately, according a major new review.


Hospital staff need to have the confidence to deal with people who have a mental health condition, according to the Treat as One NCEPOD report. Photo: Alamy

Fewer than half of those who visit hospital with a physical condition, but also happen to have a mental health problem, receive good quality care, according to the latest report from the National Confidential Enquiry into Patient Outcome and Death (NCEPOD).

The authors carried out detailed reviews of 552 cases from patients across England, Wales and Northern Ireland with a mental health condition who presented at NHS hospitals for a physical health condition. 

Issues identified in the report included a lack of staff training, inadequate mental health history being taken, not enough patients being reviewed by psychiatric teams and a lack of access to records.

Matter of urgency

The authors called for hospitals to integrate physical and mental healthcare services as a matter of urgency.

‘Good care was only provided to 46% of patients in this study, showing patients who had a mental health condition suffered the double whammy of both poor physical and mental healthcare,’ said report co-author Vivek Srivastava.

‘The systems don't exist to train hospital staff appropriately in the care of patients who also happen to have a mental health condition, so immediately there is an issue with having the confidence to care for this group of patients.

‘Once someone is admitted to hospital, it is likely to expose any underlying issue, such as a mental health problem, and staff need to have the confidence to deal with this and have access to and know how to refer to mental health services.’

Treat as One report

A online survey of 1,340 healthcare professionals as part of the Treat as One report revealed:

  • 11.4% (151 of 1,323 who responded to the question) had no training in basic mental health awareness.
  • 38.9% (497/1,276) had no training in management of self-harm.
  • 21.2% (274/1,295) had no training in assessing mental health capacity.
  • 41.4% (523/1,263) had no training on risk assessment.
  • 58.9% (727/1,234) had no training in psychotropic medications.
  • 19.1% (248/1,298) had no training in dealing with violence/ aggression.

Most of the patients in the report were admitted through the hospital emergency department and mental health conditions included schizophrenia, depression and bipolar disorder. 

RCN professional lead for mental health Ian Hulatt said the report should inform the Nursing and Midwifery Council’s work on developing new standards for education for nurses.

Recommendations in the NCEPOD report include training all staff who have interaction with patients, including clerical and security staff, in mental health conditions.

National guidelines

It also called for national guidelines outlining the expectations of general hospital staff in the management of mental health conditions.

The Centre for Mental Health’s deputy chief executive Andy Bell said: ‘This report is a stark reminder of the need for all hospitals to respond helpfully to people with mental health problems and offer care that meets all their health needs.’


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