Specialist care: People with mental health issues

Dignity in mental health care

Research has identified three key areas where the dignity of people with mental health problems is at risk:

Stigma and discrimination

Tackling stigma is an essential part of supporting people with mental health needs to maintain their dignity. People with mental health problems are one of the most excluded groups in society. Yet one in four of us will experience a mental health problem at some point in our lives.

Dignity in mental health care – what the research and policy says about stigma and discrimination

Key points

• 84 per cent of people with mental health problems experience problems in getting jobs, mortgages, healthcare, friendships, relationships (Mind survey, 2004)
• 55 per cent of young people with mental health problems wouldn't want anyone else to know about their illness (NUS and Rethink, 2001)
• 49 per cent of people with mental health problems have been harassed or attacked (Mind, Not Just Sticks and Stones, 1996)

• 33 per cent of this group report having been dismissed or forced to resign from jobs (Read and Baker, 1996)
• Attitudes in England towards mental health have worsened, contrasting with Scotland, where a strong anti-stigma campaign has changed attitudes. Only 65 per cent of people believe that people with mental health problems should have the same right to a job as anyone else. (Attitudes to Mental Illness in England 2007, CSIP/SHiFT, July 2007)

Older people’s mental health

A number of issues related to ageing can compromise mental health. They include chronic physical illness, disability, bereavement and retirement. The mental health problems that are more likely to affect older people include:

• depression
• dementia
• alcohol abuse
• problems caused by medication
• other mental health problems (such as anxiety, delirium, late onset schizophrenia).

Dignity in mental health care – what the research and policy says about older people’s mental health

Key points

When adapting Dignity in Care principles to older people with mental health problems, include people and their carers in a meaningful way.

• Build links with other organisations and develop networks to promote the needs of older people with mental health problems and their carers.
• Share skills, experiences and ideas to improve the care of older people with mental health problems

Acute inpatient care

In a consultation carried out by the Sainsbury Centre for Mental Health Service User and Carer Centered Services Research, the conditions on acute inpatient wards were the top priority.

Dignity in mental health care – what the research and policy says about acute inpatient care

Key points

•  ‘Concerns regularly raised include women hating being on the residual mixed sexed wards; safety issues; relationship with staff and boredom’  ‘Star Wards – Another Bright idea’ Bright, 2006)

• People in mental health units are far less likely to report that staff treat them with dignity and respect than those in primary and secondary care. (The 'Human Rights Insights Study’ Ipsos MORI 2005/6 conducted for the Department of Constitutional Affairs; 4,000 adults interviewed)
• Recent evidence shows significantly less satisfaction with dignity and privacy in mental health trusts than acute trusts. (Patient and Public Involvement (PPI) Forum Care Watch Report, March 2007)

What others are doing – ideas you could use

• Build partnerships  for better care
• Improve the mealtime experience
• Learn people’s life stories to improve care
• Give people who use services the chance to work

These practice examples are self-reported and have not been evaluated.