Concern over NHS trust forcing mental health patients to give up smoking

A policy banning sectioned mental health patients from smoking has come under fire amid complaints it causes unnecessary distress and has left the mentally unwell “with less freedoms than convicts”.

Smokers treated for serious mental illnesses have been forced to give up their cigarettes overnight after the main provider of mental health services in Camden rolled out a strict ban last month.

Camden and Islington NHS Foundation Trust (C&I) introduced new measures prohibiting smoking on all of its wards. At the same time, it took away access to designated smoking areas and did away with escorted smoking breaks outside its buildings.

It means people who find themselves sectioned, and thus at their most vulnerable, also now face being forced to immediately give up what can be a near lifetime habit.

Five weeks after the ban, carers have complained it has led to abusive behaviour, stress and outbursts of anger among patients.

One carer of a patient at Highgate Mental Health Centre, who did not want to be named, told the Ham&High: “It’s been a nightmare for us. With little or no time to adjust [the patient] has had tobacco taken away. It has caused us untold and unnecessary stress, which has only exacerbated the state of [the patient’s] mental health.

“If these were prisoners, we’d have riots. Those who are mentally unwell, and who have committed no crime, have less freedoms when it comes to smoking than convicts.

“It’s not that I believe smoking is good for you, but what right do they have to force patients not to smoke? Especially at a time when they are so vulnerable.”

There has also been criticism over enforcement of the policy.

Some service users told the Ham&High one patient who refused to give up their cigarettes was “pinned down” by staff, and another “put into a neck restraint”.

When C&I first announced the policy, the trust also said it would provide users with healthier activities to replace smoking breaks.

But one carer told this paper: “Patients are cooped up in a ward for 24 hours a day, with a maximum of two 30-minute ‘fresh-air’ breaks. Some of the activities they organise they don’t want to do.”

The policy follows attempts by the trust to reduce the significant proportion of its users who die from smoking.

Studies suggest up to 70 per cent of people with mental illnesses are addicted to tobacco – a proportion significantly higher than in the rest of the population. According to C&I, more than half of its service users who died from physical health conditions between 2009 and 2011 died of respiratory diseases.

In a bid to get these numbers down, its new smoking ban was introduced on March 11. Sectioned mental health patients found their tobacco immediately confiscated by staff and replaced with nicotine patches and other “nicotine replacement therapies”, including e-cigarettes.

With prisoners still able to smoke, the ban has raised questions over whether violates patients’ human rights.

A spokesman for C&I trust said: “There has been no increase in rates of agitation or restraint since the policy has been introduced. Going smoke free across our Trust will improve the mental health and physical health of our patients and staff and it is our duty to ensure the very best health for the people we care for.”