Safety Issues on British Mental Health Wards

BACKGROUND: Assuring patient safety on inpatient psychiatric units is a complex issue that involves mitigating risks as well as promoting safety by building an environment that supports engagement and constructive activity. OBJECTIVES: To review the concerns surrounding inpatient psychiatric units in the United Kingdom that led to a service user-designed program, Star Wards. The essential elements of the program are outlined along with a rationale for how Star Wards' 75 ideas effectively build greater engagement, address boredom, and enhance safety on inpatient psychiatric wards. DESIGN: This article reports on the development and dissemination of Star Wards. Included is information on the program's effectiveness; data were drawn from an evaluation of Star Wards conducted by a U. K. university. RESULTS: Psychiatric wards that have adopted Star Wards have demonstrated improvements in patient satisfaction, staff morale, levels of boredom, and incidents of aggression. CONCLUSION: Boredom and poor staff-patient engagement on psychiatric wards may contribute to aggression and violence. Drawing on Star Wards ideas, nurses and service users can work together to enhance safety via an active ward program and greater staff-patient engagement. The innovations suggested by Star Wards are practical ways to build programming and create platforms for dialogue with service users, particularly around what they need to move toward recovery.