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Mental illness, the law and rudeness

 
Monday, November 3rd, 2008

England’s smoking ban applies to psychiatric hospitals.  The smoking rooms they used to have for patients are now illegal, so patients are lighting up other places, and causing fires. 

Psychiatric units are experiencing major problems with implementation of the NHS smoking ban. Although this was implemented in other parts of the NHS last year, there was a delay until July 1 this year for psychiatric units in recognition that they would face specific difficulties.

Despite the additional time to prepare, a number of unforeseen consequences of the ban have occurred. Most alarmingly, the frequency of “small” fires on psychiatric units has increased sharply. At the mental health trust where I work, the frequency of fires has quadrupled since the start of the ban, from about one fire every two months to two fires a month. At the same time the sensitivity of smoke detectors on psychiatric wards at our trust has been reduced in an attempt to reduce the number of “false alarms” triggered by smoking in enclosed areas and unnecessary calls to the fire brigade.

The increase in the number of fires is thought to be the result of patients no longer being supervised smoking in a “smoking room” and instead resorting to smoking in their bedrooms and the toilets. Whereas previously patients’ cigarettes would either be lit by staff or from a wall-mounted lighter, there is now widespread possession of lighters and matches by patients, and patients are easily able to circumvent body searches.

On October 15, a fire at Camlet Lodge secure psychiatric unit in north London caused an estimated £60m of damage and the evacuation of 60 patients to another facility; fortunately, no one was injured. Camlet Lodge is a modern purpose-built unit meeting current fire standards. Unfortunately, many psychiatric units are still housed in old Victorian buildings.

Staff in the frontline of implementing the smoking ban are at a loss what to do. Attempts to raise this issue with hospital managers at my trust have not produced any practical solution, as managers feel their hands are tied by the Health Act 2006. Surely it was not parliament’s intention when they passed the smoking ban to cause risk to life and limb. Public debate on this issue is urgently required before there is a significant loss of life in a fire at an NHS psychiatric hospital.

Source: The Guardian.  Link

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