Re-adjusting to life in the community following a period spent as an inpatient in an acute mental health ward can be extremely difficult. Research shows that participation in structured activities during this time can prevent boredom, improve their relationships with ward staff and help ease their transition out of hospital.
Activities can be valuable for people at high risk of hospital readmission, stigma or exclusion in their community – which is often the case for people living with psychosis. However, feedback from service users suggests that there is not enough choice of activities on offer and that staff are often too busy to provide regular activities, particularly on evenings and weekends.
In 2023, Maudsley Charity funded a project at King’s College London to research the provision of activities on wards, particularly for people living with psychosis. The team worked closely with experts by experience and with a Project Advisory Panel to help refine their approach and inform their interpretation of the data that was gathered.
The researchers began by mapping the activities provided across 12 acute mental health wards at Bethlem, Maudsley and Lewisham hospitals. They then made daily visits to seven of these wards over a month, observing activities and speaking to patients, carers, and staff about what made various activities meaningful to people living with psychosis.
Following analysis of their observation data, the research team hosted an event at ORTUS to share and discuss their findings with a group of over 40 people, including people with lived experience and healthcare professionals such as nurses, occupational therapists, healthcare assistants, and activity coordinators. Feedback from this event helped the researchers to establish a consensus around what works – and why.
Their initial findings indicate that physical activities like gardening and cooking, music- based activities and relaxation were favoured activities by people living with psychosis.
These activities provide numerous benefits including creating positive connections, inspiring hope and optimism, providing autonomy and outlets for expression and boosting physical well-being. Though not a key objective, activities also help patients develop the skills to relieve boredom and manage their time contributing to a safer and less tense ward environment.
For activities to deliver these benefits, they need to be of a high quality, i.e. well-structured and delivered by trained facilitators. There needs to be a shared vision about the importance of ward activities across the entire team and senior staff, with the necessary resources provided so all staff can incorporate it into their roles, not just occupational therapists and activities coordinators.
The project team delivered their formal report in July 2024 and already, their initial findings have been quoted extensively as part of NHS England’s 2024 Culture of Care report. It is anticipated that their work will inspire and inform best practice so that ultimately delivery of activities is embedded into daily ward routine.
Joseph on quality time and activities for inpatients
