Creating constructive acute in-patient stays (ARCHIVED)

by Marion Janner


Last updated: February 2016 by Geoff Brennan


Please note: This module has now been archived.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 staff.


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.


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If you like this module, you may also be interested in:


Involving patients and carers in training  by Dr Alka Ahuja 


Managing challenging behaviour in mental health in-patient units by Dr Dominic Beer and Mr Darryl Anthony Davis


Alternatives to acute admission: crisis resolution and home treatment by Dr Christopher Bridgett



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