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There is evidence that novel psychoactive substances (NPS) are commonly used by people with severe mental illness. The purpose of this paper is to undertake a scoping survey to explore the inpatient mental health workers’ perceptions of NPS use by consumers.

A cross-sectional online survey of mental health professionals is used in the study. The participants were opportunistically recruited through social media and professional networks.

A total of 98 participants (of 175 who started the survey) were included in the analysis. All reported that some patients had used NPS prior to admission. Over 90 per cent of participants reported observing at least one adverse event relating to NPS use in the previous month. The majority of participants reported that patients had used NPS during their inpatient admission. Three quarters were not clear if their workplace had a policy about NPS. Most wanted access to specific NPS information and training. The participants reported that they lacked the necessary knowledge and skills to manage NPS use in the patients they worked with.

Whilst the authors are cautious about the generalisability (due to methodological limitations), the findings provide useful insight into the perceptions of inpatient staff regarding the extent and impact of NPS use including concerns regarding the impact on mental and physical health, as well as ease of availability and a need for specific training and guidance.

Mental health professionals require access to reliable and up-to-date information on changing trends in substance use. Local policies need to include guidance on the safe clinical management of substance use and ensure that NPS information is included.

To the best of the authors’ knowledge, this is the first survey of the perceptions of mental health staff working in inpatient mental health settings regarding NPS. The findings suggest that NPS is a common phenomenon in inpatient mental health settings, and there is a need for more research on the impact of NPS on people with mental health problems.

This position paper focuses on the current tensions and challenges of aligning inpatient care with innovations in mental health services. It argues that a cultural shift is required within inpatient services. Obstacles to change including traditional perceptions of the role and responsibilities of the psychiatrist are discussed. The paper urges all staff working in acute care to reflect on the service that they provide, and to consider how the adoption of new ways of working might revolutionise the organisational culture. This cultural shift offers inpatient staff the opportunity to fully utilise their expertise. New ways of working may be perceived as a threat to existing roles and responsibilities or as an exciting opportunity for professional development with increased job satisfaction. Above all, the move to new ways of working, which is gathering pace throughout the UK, could offer service users1 a quality of care that meets their needs and expectations.

In this article we explore how inpatient mental health services in England and Wales are interpreting and responding to policy derived from Mainstreaming Gender and Women's Mental Health (DH, 2003) in relation to women's safety in inpatient settings. This article will outline the background to concerns about safety in mental health settings for women and drawing on relevant literature and on interviews with service managers, practitioners and users identify some current issues in improving safety for women in inpatient settings and in creating single sex provision. Our review suggests that whilst there are improvements in provision for women in inpatient settings, some women are still not being offered a real choice of a women‐only setting on admission to hospital, and that changing the culture that permits a lack of physical and relational safety for women presents real challenges. We will discuss some of the implications for future practice.

This paper aims to explore inpatient staff experiences of seeking to meet the religious and cultural needs of Black, Asian and Minority Ethnic (BAME) inpatients on mental health wards.

Nine semi-structured interviews were undertaken with inpatient staff in one NHS Trust in England to explore their views and experiences of supporting BAME inpatients to meet their religious and cultural needs. Anonymised transcripts were analysed thematically.

Inpatient staff reported lacking the confidence and knowledge to identify and meet BAME inpatients’ religious and cultural needs, especially inpatients from smaller ethnic groups and newly emerging communities. There was no specific assessment used to identify religious and cultural needs and not all inpatient staff received training on meeting these needs. Concerns were raised about difficulties for staff in differentiating whether unusual beliefs and practices were expressions of religiosity or delusions. Staff identified the potential role of inpatients’ family members in identifying and meeting needs, explaining religious and cultural beliefs and practices, and psychoeducation to encourage treatment or medication adherence.

Potential ways to address this gap in the knowledge and confidence of inpatient staff to meet the religious and cultural needs of BAME patients include training for inpatient staff; the production and updating of a directory of common religious and cultural practices and needs; local resources which can help to support those needs; and religious and cultural practices and needs being documented by mental health practitioners in community teams such that this information is readily available for inpatient staff if a service user is admitted.

This is the first study to consider inpatient staff views on meeting the religious and cultural needs of BAME informal patients and patients detained under the Mental Health Act 1983.

As the use of drugs and alcohol by clients accessing mental health services becomes increasingly common, members of staff working within psychiatric inpatient areas often encounter drug and alcohol misuse among their client group. The safe and effective management of this issue has become a priority for many inpatient services. This paper outlines a policy for the management of substance misuse on psychiatric inpatient wards developed by Manchester Mental Health and Social Care Trust. The fundamental principles underpinning the policy are highlighted, and the key sections of the policy are described. There is a detailed description of how the policy has been applied in practice by members of staff working on inpatient wards, with clinical examples being presented.

Transition from inpatient mental health care to community living can be very difficult, as people are at an increased risk of suicide, self-harm and ultimately readmission into hospital. There is little research conducted exploring peer support workers’ (PSWs) lived experiences that could provide insight into the key transitions of care, particularly the support required after discharge from inpatient mental health care. The purpose of this paper is thus to provide a particular insight into what it feels like being discharged from psychiatric care from a PSW’s perspective, how may support be improved post-discharge and what factors might impact the potential for readmission into inpatient care.

A qualitative, phenomenological approach was adopted to explore and describe PSWs’ lived experiences of transitioning from psychiatric care. Four PSWs who were employed by a UK secure mental health facility were recruited. PSW is a non-clinical role with their main duty to support patients, and they were considered for this type of the study for their experience in negotiating the discharge process to better carry out their job as a PSW.

After being discharged from psychiatric care, PSWs experienced issues that had either a negative impact on their mental wellbeing or even resulted in their readmission back into inpatient psychiatric care. This study identified three inter-related recurrent themes – continuity of support, having options and realisation, all concerning difficulties in adjusting to independent community life following discharge. The findings of the study highlighted the importance of ensuring that service users should be actively involved in their discharge planning, and the use of effective post-discharge planning processes should be used as a crucial step to avoid readmission.

A deeper insight into the factors that impact on readmission to secure care is needed. The active involvement of service users in effective pre- and post-discharge planning is crucial to avoid readmission.

Mental health professionals should consider developing more effective discharge interventions in collaboration with service users; inpatient services should consider creating more effective post-discharge information care and support packages. Their lived experience empowers PSWs to play a key role in guiding patients in the discharge process.

This is the first study, to the best of the authors’ knowledge, to explore what it feels like being discharged from inpatient mental health care by interviewing PSWs employed at a forensic mental health hospital by adopting a phenomenological approach. This paper offers a deeper insight into the transition process and explores in detail what support is needed post discharge to avoid potential readmission from PSWs’ perspectives.

Dual diagnosis poses particular challenges for inpatient mental health services. Workers have low levels of training, clinical experience and support to deliver integrated care that combines mental health and substance use interventions. In addition, inpatient workers have to balance being therapeutic with ensuring that illicit substance use does not occur on the wards. This often leads to confrontation and poor engagement.In order to improve the capabilities of the workers to deliver more effective interventions for this group of service users, dual diagnosis training should be a high priority for acute inpatient services. However, there are a number of challenges in the implementation of this including lack of resources to fund training and specialist roles, lack of time to attend training (and supervision), and lack of time to implement learning in routine care.This paper will describe the policy drivers for the improvement of dual diagnosis care in acute psychiatric inpatient services, and how two initiatives in London are overcoming some of the obstacles and showing some promising initial outcomes. This paper will make recommendations for future research and developments.

Addressing the needs of people with a dual diagnosis is a core component of acute inpatient mental healthcare. In 2006/2007, the Healthcare Commission conducted a national review of NHS acute inpatient wards in England. The review included five indicators of particular relevance to working with people with a dual diagnosis. This paper provides an overview of the review process, reports the dual diagnosis findings and considers their implications for improving the care and treatment of people with a dual diagnosis in the inpatient setting.

This paper looks at the evolving nature of mental health services. While there has been a shift from asylums to care in the community in recent decades, what is now needed is another shift of acute inpatient psychiatric care, away from psychiatric units to community hospitals and other community settings. It is argued that this would be a further step forward in the evolution of mental health services as it would benefit the service users, their families, carers and staff working in acute psychiatric inpatient units.