Welcome to the latest issue of SWAN. Malcolm and I are in planning mode for the momentum meeting – the big get-together of all the pilot sites. It’s going to be an amazing day, with the sharing of excellence in practice from the most dynamic and effective wards in the country. The date is July 4^th and we’re very grateful to Neil Carr and colleagues in Staffordshire for hosting the event. The accompanying email has suggested programme contents and we look forward to getting your feedback – and also offers of running particular sessions.

News from trusts

I was particularly pleased to be able to visit the mental health trust of the hospital (St Ann’s) where Star Wards was conceived, when I was a detained but soon very content inpatient. I ran a training session for 40 of Barnet, Enfield and Haringey MH Trust’s ward managers and was delighted that there’s so much good practice in the trust. One initiative which made me smile is… Medication with a Smile. Given the problematic relationship that many patients have with their medication (not me – can’t get enough of mine) I was curious about how this approach, and name, has gone down. Because the focus is on giving patients as much information and choice as possible, and eliminating the ghastly queuing for medication, it seems that patients are very positive about it.

Ideas in action

#32 Pets as visitors and residents

This is the suggestion that has, by far, raised the most interest. There are loads of big benefits of inpatients having contact with pets, beyond those gained by non-psychiatric patients, because of the specific impact of mental illness and the fact that mental health inpatients have longer average periods of hospitalistion. There are also none of the specific infection control issues of patients who are physically vulnerable. Benefits include:

• Having an external focus – i.e. beyond one’s own symptoms and situation
• Emotional and physical comfort
• Focus of interaction and conversation with other patients, visitors and staff
• The blissfully accepting, non-judgmental and appreciative, nature of pets – fabulous for enhancing self-esteem
• An important connection with home when patients’ own pets can visit
• A connectedness with ‘reality’ for psychotic patients

THE LEGAL SITUATION

There isn’t one! The Health & Safety Executive say there’s no legislation preventing pets on wards. It all comes down to risk assessments. So – it’s a green light for pets on mental health wards! It would be really good to hear from you about your experiences, including obstacles you’ve faced and perhaps overcome.

OPTIONS

• Types of pets:
  • Cute and rodenty – mice, hamsters, rabbits. OK, guinea pigs too but I can’t personally see the point of these.
  • Cats and dogs
• Status – any one or combination of the following could be introduced:
  • Resident – no particular issues beyond those covered below, other than inappropriateness of dogs being kept on leads
  • Pets as Therapy (PAT) – the least controversial of patients having contact with pets, as carefully selected pets are brought in by volunteers
  • Visitors bringing pets, especially patients’ own pets. Buddy’s illicit visit was one of the highlights of my stay at St Ann’s. Luckily she’s so hairy that she could be smuggled in as a pair of interactive slippers

CHALLENGES

• Health and safety:
  • With resident and PAT animals, you can ensure they’ve had all the necessary vaccinations, flea and worm stuff etc
  • Cats and dogs relieving themselves shortly before they reach the garden. Worse gets spilt on wards and it can be easily mopped up
  • Tripping over-type accidents. Given the physical risks of being on a ward, this can’t be an issue
• Behaviour:
  • Again, no problem with resident and PAT animals
  • Keeping dogs on a lead addresses most of the potential problems
• Allergies and aversion
  • If individual patients have problems with this, wards can pair up to temporarily look after a pet
• Care of resident pets
  • Costs are minimal – apart from potential vet fees
  • Walking dogs – wonderful to have a built-in reason for patients to go for walks, and motivating when the prospect of any physical exertion beyond stabbing the remote control buttons is off-putting

www.petsastherapy.org

http://www.psych.org/pnews/01-02-02/petting.html

All the best

Marion