David Lee on drugs and safer services

The safer services agenda is never far off the radar of a mental health trust manager. This is often connected to the range of substance misuse issues that constantly confront mental health services.

In Camden and Islington in north London we have used a package of measures including dual diagnosis training, local security management specialists, our interface with multi-agency public protection arrangements and the deployment of a criminal justice consultant. One project has attracted particular interest ñ µ³ing dogs to search wards for drugs.

The decision to go ahead with a six-month pilot, to be fully evaluated, was taken by the board last year. A working party made up of staff and user representatives has overseen the project throughout.

As with all successful projects, good people make the difference. In particular, when appointing our criminal justice consultant, we did not just buy a copper. We were lucky to have a recently retired local senior officer with an uncommon empathy for the needs of mental health service users. The pilot has also benefited from the active engagement of service user groups, frontline staff and the Metropolitan Police.

Before the pilot, views from service users about the use of drug dogs were, at best, mixed. Pre and post-pilot questionnaires were circulated to staff, service users, carers and visitors to complete anonymously.

Searches were conducted by the Metropolitan Police dog section in nine wards, on request from the criminal justice consultant and in consultation with modern matrons and ward managers. No formal complaints about the searches were received. The consensus among staff was that the searches had a positive effect on the wards. Concerns that the searches could arouse aggressive responses proved unfounded.

Comparison of the pre and post-pilot questionnaires showed some significant changes. The proportion who felt they had been affected by the use of illicit drugs was down from 48 per cent to 21 per cent. Numbers of people who had witnessed the use of drugs, been asked to carry illicit drugs, been offered drugs or had used illicit drugs were at least halved.

The number of people affected by violence was down from 71 per cent before the pilot to 27 per cent after it. People who regarded themselves as victims of aggression dropped from 32 per cent to 24 per cent.

The number of people who thought incidents of aggression were due to someone being under the influence of illicit drugs dropped from 45 per cent to 30 per cent. And the proportion who reported feeling safe in the sites rose from 48 per cent before the project to 58 per cent.

There are no magic wands when it comes to combating illicit drugs on our wards but the drug dogs pilot has certainly given us plenty to think about in our ongoing struggle for safer services.

David Lee is director of strategic development at Camden and Islington Mental Health and Social Care trust.