Psychiatric units in England are experiencing considerable difficulties implementing the smoking ban, says Clare Allan
Jump to full article: The Guardian (uk), 2009-07-01
Author: Clare Allan
Intro: Psychiatric units in England are experiencing considerable difficulties implementing the smoking ban that came into force last July. A report published last month by the Mental Health Foundation (MHF) says 85% of respondents to a survey it conducted said the ban had not been implemented "wholly effectively". Widespread practical problems reported included a rise in "secret smoking" - with associated safety concerns - and occasions where staff feel obliged to "turn a blind eye", especially when a patient is very unwell, thus placing them both in a position of breaking the law.
Two years ago, I wrote a piece expressing my concerns about the forthcoming ban. It seemed to me that the issue was a great deal more complex, both practically and morally, than a simple equation of "smoking is bad, therefore we must ban smoking". . . .
Policy-makers responded with a mixture of "guidance" and bullheadedness. "The 'smoking den' culture that has afflicted mental health wards for decades is over," said national director for mental health Louis Appleby, in a letter to this paper more than a year before the ban was even due to be brought in.
Some trusts have introduced the ban effectively, and their experience is informative. One trust quoted in the MHF report had introduced the ban in conjunction with "healthy lifestyle initiatives". It said that "every ward has stretch and movement to start the day, a gym, and staff trained to diploma level in physical healthcare".
If stopping smoking is to be seen as a positive choice, rather than the loss of yet another freedom, such initiatives would seem to be crucial, as would a healthy, nutrition-rich diet. I have never been on a ward that offered either.
My local mental health unit, which was purpose-built only a few years ago, does not have a gym at all. Nor, crucially, do wards have direct access to a safe outside space. . . .
If every ward could be provided with such facilities, most people would embrace the ban as a huge step forward. But that is not the reality most staff and patients face. . . .
The fact is that psychiatric wards contain people who are ill - some too ill to leave the ward and certainly too ill to appreciate the benefits of not smoking. In the interests of common humanity, staff are turning a blind eye and breaking the law. They shouldn't have to.
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