Substance use amongst inpatients on mental health wards: practical guide for mental health services

Guidance for NHS health boards providing inpatient mental health services on responding to substance use on mental health wards. This should be used in conjunction with existing local guidance for responding to substance use incidents on inpatient wards.

1. Introduction

Mental health inpatient wards provide care and treatment for people suffering from mental ill health at a time when they cannot safely receive treatment at home. Following the Independent Inquiry into Mental Health Services in Tayside, the final report by David Strang, ‘Trust and Respect’, identified the prevalence of substance use within inpatient wards as an area of concern, and specifically highlighted the problems encountered in responding to the use of substances in these clinical areas.

Strang set out the tensions in managing illicit substance use, determining that in the absence of a consistent response patients and staff were left at risk. Strang noted that “A national approach to guidance on managing illicit substances in hospitals is required.”

The Scottish Government is responsible for responding to both the local and national recommendations within ‘Trust and Respect’. Working in collaboration with a range of professionals, the following national guidance has been developed to help address some of the issues identified in the report, and promote a more consistent response to this issue across Scotland. This guidance has been designed to complement both the implementation of the Medication Assisted Treatment (MAT) standards, as well as current local guidance.



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