The restrictions of the mental health unit made me worse, says Fishguard patient

Francesca Murphy was still wearing her school uniform when she was admitted to the Adult Mental Health Unit.

He was 18 years old, still in school and very scared.

Mind Cymru said there were concerns about staff shortages, care planning and the use of restraints in inpatient mental health units across Wales.

The Welsh Government has announced it has invested £2m in the improvements.

Ms Murphy, now 27, said her life changed dramatically after a sailing accident in 2014.

He was trapped under his boat after it capsized with a rope around his ankle.

She was rescued and physically fine, but this led to a rapid decline in her mental health, leading to self-harm and suicide attempts.

He was admitted to the Children and Adolescent Inpatient Unit, but was released back into the community the day before his 18th birthday.

Since then he has volunteered at various mental health inpatient units in Wales and England.

Ms Murphy, from Fishguard, Pembrokeshire, said: “I was what you would call a revolving door patient.”

He went missing before being picked up by police and temporarily hospitalized before being released two days later.

“The circle would go round,” he added.

His longest hospital stay was six to seven months.

Without the support she received from her psychotherapist, she said she would not be here today.

However, he also spoke of some hospital experiences where he was subjected to physical and pharmacological restraints that were traumatic.

He was pinned face down at least twice.

Restraint or restrictive practice should always be a last resort and attempts should be made to calm volatile situations beforehand.

“[It was] terrible. I had three men and one woman holding my four limbs and injecting me and sedating me before talking to me to ease the situation,” he said.

“One time I remember clearly hearing, ‘Let’s just get him in the room.’

“I was still trying really hard to get over the memories of the sailing incident, and when there was something around my ankle, that triggered everything that happened.

“That would make me even worse.”

Ms Murphy agreed that improvements were needed in inpatient mental health units.

Continuity of care and clear communication are critical, she said.

“If you say you’re going to do something, do it. Don’t say you’re going to do something and then not follow through.

“I was lucky to have an incredible therapist who looked at me holistically, and they worked with my family … a lot of professionals didn’t talk to them,” she said.

She also said there was a lack of training in eating disorders in general psychiatric wards.

Ms Murphy has now been discharged from the mental health service and is working two jobs, coaching sailing and getting back into the water.

“I want to speak for the people who are no longer here to advocate.”

He contributed to a A new report from Mind Cymru which focuses on mental health inpatient wards in Wales.

Concerns were raised about staff shortages, lack of data and general maintenance and safety.

The charity found that 13 out of 18 hospitals reported problems with staff shortages in 2022-23, which had a negative impact on patients.

It also says more comprehensive data collection is needed to get a more complete picture of inpatient treatment and restraints, particularly on race and other protected characteristics, to combat all forms of inequality and discrimination.

It identified several areas for improvement, including the need to bring restrictive practices legislation into line with English law.

Across the board, the Mental Health Units (Use of Force) Act 2018 (known as the Sen Act) aims to protect patients from the use of disproportionate and inappropriate force.

Tutoring is not compulsory in Wales.

Mind Cymru’s Simon Jones said there are similar guidelines in Wales, but they must be legal requirements.

“The statutory element adds legal protection and the data that is collected is more transparent, so we want to see that in Wales so we’re really clear about what’s going on,” he added.

The Welsh Government said improving the safety and quality of mental health is a priority.

He said this was reflected in a £2m investment to improve services, which included a mental health patient safety programme.

“We recently consulted on our draft Mental Health and Wellbeing Strategy, which was developed in collaboration with a number of partners, including service users and carers, and which sets out our vision for improvements over the next 10 years,” he added.

If you or someone you know has been affected by mental health issues or self-harm, help and support is available at BBC action line