The relationship between substance use and exit security on psychiatric wards

Area of Science:

• Psychiatric Nursing
• Addiction Research
• Healthcare Security

Background:

• Inpatient psychiatric wards often employ locked doors due to staff concerns about patient safety and illicit substance entry.
• The therapeutic environment can be compromised by patient absconding and the introduction of drugs or alcohol.

Purpose of the Study:

• To investigate the relationship between drug and alcohol use rates on acute psychiatric wards and the intensity of exit security measures.
• To determine if enhanced security correlates with reduced substance misuse.

Main Methods:

• A cross-sectional survey of 136 acute psychiatric wards in England was conducted over six months.
• Data on door locking, exit security, and drug/alcohol use were collected and analyzed.
• Supplementary data on security measures were gathered in a subsequent year.

Main Results:

• No significant association was found between ward door locking, exit security features, or monitoring intensity and drug/alcohol use rates.
• Preliminary evidence suggests breath testing may decrease alcohol use, while 'sniffer' dogs were linked to increased alcohol consumption.
• No consistent relationships were observed between security measures and substance misuse.

Conclusions:

• Enhanced exit security and locked ward doors do not influence inpatient drug or alcohol use.
• Screening interventions, such as breath testing, show potential for reducing substance misuse and associated issues like verbal abuse.
• Current security strategies are ineffective in controlling inpatient substance use.