• An HSJ investigation has found there were more than 3,000 reported sexual assaults at mental health trusts from 2013-14 to 2017-18
  • The number of reported sexual assaults by patients on staff and patients rose by 17 per cent from 576 to 676 during the same time period
  • The Care Quality Commission launched an investigation into the issue in April and is expected to publish its report and recommendations in the next few weeks

The number of staff and patients reporting being sexually abused by mental health patients has risen by nearly a fifth with more than 3,000 cases over the last five years, an HSJ investigation can reveal.

New figures from 46 out of 54 mental health trusts show there were 3,147 reports of patients sexually assaulting staff and other patients between 2013-14 and last year [2017-18].

HSJ’s freedom of information requests revealed reports of patients sexually assaulting staff and patients rose by 17 per cent, from 576 to 676, over the same period, with the number of reports peaking at 711 in 2016-17.

However, some of the trusts did not provide data for all the years requested and others could not separate sexual incidents from assaults, meaning the total numbers could be much higher. The number of reports found to be proven was not known, and the extent to which an increased likelihood of assaults being reported may have impacted on the figures is unclear.

The numbers have sparked concerns from mental health campaigners and charities, with Rethink Mental Illness saying they were “shocking and appalling”.

The charity’s head of health influencing Lucy Schonegevel told HSJ that trusts had to eliminate mixed sex wards and work with service users to make sure wards were safer places for patients.

She added: “It’s shocking and appalling. Vulnerable people on these wards should not have to go through further trauma when they may have already experienced a significant amount in their lives.

“Mental health wards should be a place of safety.”

The Care Quality Commission launched an investigation into how mental health patients are protected from sexual abuse in April, sparked by the watchdog identifying 900 incidents on wards in just three months and finding a trust breaching rules on mixed sex wards.

Its State of Care in Mental Health Services report, published last year, said there were a “substantial number” of services with mixed sex units. This was despite the government ordering NHS providers in 2011-12 to eliminate mixed sex accommodation in almost all circumstances.

Dr Paul Lelliott, the deputy chief inspector of hospitals and lead for mental health, said staff on mental health wards have a “heightened responsibility” to ensure patients are protected from sexual harassment and sexual violence.

He added: “The distress and emotional harm caused by sexual incidents can be long lasting and will often still be felt after people leave hospital, even impacting long term recovery for some.

“We have been looking at how trusts report and act on sexual incidents and will be reporting on these findings in the coming weeks including recommendations for the system on how to improve sexual safety for patients and staff on mental health wards.” 

Reports of sexual assault by patients at mental health trusts*

Trust name2013-142014-152015-162016-172017-18Total
Birmingham and Solihull Mental Health NHS Foundation Trust 56 92 102 96 57 403
Devon Partnership NHS Trust 55 48 59 79 75 316
Northumberland, Tyne and Wear NHS Foundation Trust 61 37 59 47 62 266
Coventry and Warwickshire Partnership NHS Trust 25 47 51 44 73 240
Sussex Partnership NHS Foundation Trust 24 31 26 30 36 147
West London Mental Health NHS Trust 31 35 26 26 24 142
Cheshire and Wirral Partnership NHS Foundation Trust 31 29 15 32 30 137
South London and Maudsley NHS Foundation Trust 26 15 28 30 16 115
South West London and St George’s Mental Health NHS Trust 30 11 11 27 25 104
Mersey Care NHS Foundation Trust 7 12 37 23 21 100
Hertfordshire Partnership University NHS Foundation Trust 37 15 3 16 26 97
Berkshire Healthcare NHS Foundation Trust 1 3 9 33 46 92
Surrey and Borders Partnership NHS Foundation Trust 17 16 9 24 19 85
Bradford District Care Foundation Trust 26 10 17 14 10 77
Nottinghamshire Healthcare NHS Foundation Trust 9 20 11 19 13 72
Lincolnshire Partnership NHS Foundation Trust 9 16 16 11 15 67
Solent NHS Trust 8 14 10 13 8 53
South West Yorkshire Partnership NHS Foundation Trust 2 11 9 16 14 52
Barnet, Enfield and Haringey Mental Health NHS Trust     11 18 12 41
Humber NHS Foundation Trust 8 9 5 5 12 39
Oxleas NHS Foundation Trust 5 13 10 5 6 39
North Staffordshire Combined Healthcare NHS Trust 2 8 8 7 6 31
Somerset Partnership NHS Foundation Trust 5 4 4 8 9 30
Northamptonshire Healthcare NHS Foundation Trust 0 0 0 6 17 23
2gether NHS Foundation Trust       16 5 21
Norfolk and Suffolk NHS Foundation Trust 6 8 3 1 0 18
East London NHS Foundation Trust 3 1 2 0 1 7
Tavistock and Portman NHS Foundation Trust 0 0 0 0 0 0

* While 45 trusts responded to HSJ’s information requests, only 28 provided data in relation to reported sexual assaults by patients on staff and other patients. Some of the remaining trusts only provided figures for individual years, so were not included in the table, although they make up part of the 3,147 total.

Responses from trusts

Northumberland, Tyne and Wear Foundation Trust’s chief operating officer and nursing director Gary O’Hare said the trust provided services to a “complex” patient population including local, regional and nationally commissioned services.

He added: “We have continually developed our incident reporting system to be one of the most open and transparent in mental health services. Our comprehensive approach to reporting, as well as our staff’s willingness to report incidents, has been identified as positive practice by the Care Quality Commission.”

Coventry and Warwickshire Partnership Trust’s chief executive Simon Gilby said his trust prided itself on being open and transparent with a positive reporting culture. He said the data included both mental health and learning disability patients and added: “The number of serious incidents is very small but all are fully investigated, including ensuring that robust safeguarding processes are in place. We take the safety of our patients and staff seriously at all times.”

A Birmingham and Solihull Mental Health spokeswoman said the FT had seen a substantial drop in sexual assaults against staff and patients between 2015-16 and 2017-18. She added: “We continue to work hard to reduce the number of physical assaults as part of our trust’s quality strategy and goals.”

HSJ’s investigation also found:

  • There were 1,401 reports of patients sexually assaulting other patients, peaking at 301 in 2016-17 but only rising from 283 to 285 during the time period;
  • there were 1,423 reports of staff being sexually assaulted by patients, spiking by nearly 63 per cent, from 221 to 360, during the same time period; 
  • the number of sexual incidents – including inappropriate comments, harassment, molestation and exposure – increased by 57 per cent from 2,565 in 2013-14 to 4,040 last year; and
  • a total of 944 incidents were reported to the police during the time period, peaking at 234 reports in 2015-16.

NHS Providers’ deputy director of policy and strategy Miriam Deakin said the safety of staff and patients was an “absolute priority” for trusts.

She added: “But these concerns reinforce the importance of ensuring that funding earmarked for mental health gets through to frontline services to enable trusts to manage rising pressures on local services.

“Workforce shortages must be addressed as a matter of the utmost urgency.”

An NHS Improvement spokesman told HSJ it was working with the CQC on a range of preventive measures to improve safety on mental health wards

He said: “Ensuring the safety and wellbeing of all patients and staff on hospital wards is a priority for the NHS. Therefore, we expect all NHS trusts to take a zero tolerance approach to sexual safety incidents occurring within their organisations.”

Freedom of information requests by Channel Five News published in May found 446 cases of alleged misconduct by staff, ranging from inappropriate comments to sexual assault and rape, were reported and investigated at mental health trusts between 2013 and 2017.

A Department of Health and Social Care spokeswoman said it expected hospitals to take allegations extremely seriously and inform the police where necessary.

She added: “The safety of patients is our number one priority and the CQC are currently working with NHS Improvement on how trusts report and act on these incidents, and will be reporting on findings later in the year.”

“Suffering in silence” - victims of sexual abuse on mental health wards

One woman told HSJ she was harassed and exploited by a male patient while on a mixed sex ward after being detained under the Mental Health Act in 2007.

The woman, who cannot be named for legal reasons, said the exploitation eventually led to the man sexually and emotionally abusing her, both in and out of the hospital.

She added: “All I can say about my mind at that time was it wasn’t something I wanted – actually it was like my nightmare.

“I don’t think I was in any state of mind to think I was being abused. I blamed myself really for it all.”

She told HSJ she buried the abuse for six years before she addressed what had happened, but that it had a major impact on her care and recovery.

She added: “That had a huge detrimental effect on my mental health and meant I could not engage with the therapy I was given at that time. It completely collapsed, and I completely collapsed.”

She said no unit should be mixed sex and added: “That’s where the NHS needs to learn that where recommendations are made it doesn’t mean they can ignore them.

“I was a human cost, and not just a human cost, I was a financial cost because I couldn’t engage with treatment and ended up [in a] revolving door.”

Another woman told HSJ she had been sexually abused multiple times on mental health wards from her first admission in 1993 to her latest in 2003.

The 48 year old said she was targeted by male nurses but other staff would not believe her.

She said the first experience had such a bad effect on her that it put her off going to hospital even when she was very unwell.

She added: “I would absolutely not go to hospital. So then you suffer in silence until it passes thinking ‘why would I go back to a situation where I was sexually assaulted?’”

One of the problems she and others have faced is being believed when they raised allegations of sexual abuse on wards.

She added: “When I said to one of the nurses she just basically said I was being a drama queen and making a mountain out of a mole hill, [saying] ‘I know him, and he would never do that’.

“We need to get away from this idea that if you have a mental health problem you’re not that credible, you’re not reliable.”