Inpatient dementia mental health care in the UK: a national mapping survey of ward provision and family carer involvement

Objectives

Inpatient mental health wards provide specialist care for people with dementia experiencing acute behavioural disturbance. The scale and configuration of this provision, and how these services involve family carers, have not previously been described at a national level. This study aimed to map ward provision across the UK and characterise existing policies and practices related to carer involvement.

Methods

A national cross-sectional online mapping survey was conducted across mental health wards providing care for people with dementia in the UK. Wards were identified through a structured multi-source search strategy. The survey captured ward characteristics, patient profile, staffing and approaches to carer involvement. Quantitative data were analysed descriptively; Fisher's exact test was used to examine associations between categorical variables.

Results

209 wards comprising over 3100 beds across 80 provider organisations were identified. 63 wards (30.1%) participated, reporting 801 patients. Most patients were detained under mental health or capacity legislation (87.8%) and few were expected to return home (14.8%). While all wards reported involving carers in clinical decision-making, 44.4% indicated carers did not routinely attend MDT meetings and 30.2% did not routinely share care plans. Staff training in carer engagement was a consistent marker of greater carer involvement across multiple measures.

Conclusions

This survey provides the first national picture of inpatient dementia mental health care in the UK, revealing a service under considerable pressure and a consistent gap between the basic infrastructure for carer involvement and its meaningful integration into clinical practice. Staff training in carer engagement was strongly associated with greater carer involvement, pointing to an actionable route to improvement.