module has now been archived. It is still available to view, but
please be aware when completing the module that it was last
reviewed in 2016. A CPD certificate is available for the module,
but this will be subject to the approval of your peer
group. If you are a consultant-level psychiatrist interested
in updating this material, please contact us
There used to be almost total consensus about the
poverty of acute in-patient stays.
'As we all know, acute units have
been starved of resources, marginalised when it comes to service
development, and then criticised for an excessively custodial form
of care.' Consultant psychiatrist quoted in The
Search for Acute Solutions (Sainsbury
Centre for Mental Health, 2006).
It wasn't so much the locked doors (even
on ostensibly ‘open wards’) that created the custodial environment,
but the culture of staff ‘watching and waiting’. This very passive
approach, combined with an almost total absence of resources and
activities for patients, produced days and weeks characterised by
boredom, frustration and lack of development, for both patients and
But acute care is changing. Very much for the
better, in terms of therapeutic input, patient involvement in their
own care, and meaningful activities. Improved staff satisfaction
and motivation is both cause and effect of these improvements.
Informed by the author's own experience of being an acute mental
health in-patient, this module looks at some of the key components
of constructive acute in-patient wards and the role of the
psychiatrist in enabling positive changes.
Start the module