City Research Online

The relationship between substance use and exit security on psychiatric wards

Simpson, A., Bowers, L., Haglund, K. , Muir-Cochrane, E., Nijman, H. & van der Merwe, M. (2011). The relationship between substance use and exit security on psychiatric wards. Journal Of Advanced Nursing, 67(3), pp. 519-530. doi: 10.1111/j.1365-2648.2010.05499.x


Aim.  In this paper we report on the rates of drug/alcohol use on acute psychiatric wards in relation to levels and intensity of exit security measures.

Background.  Many inpatient wards have become permanently locked, with staff concerned about the risk of patients leaving the ward and harming themselves or others, and of people bringing illicit substances into the therapeutic environment.

Methods.  In 2004/2005, a cross sectional survey on 136 acute psychiatric wards across three areas of England was undertaken. A comprehensive range of data including door locking and drug/alcohol use were collected over 6 months on each ward. In 2006, supplementary data on door locking and exit security were collected. Door locking, additional exit security measures and substance misuse rates of the 136 wards were analysed and the associations between these were investigated.

Results.  No consistent relationships were found with exit security features, intensity of drug/alcohol monitoring procedures, or the locking of the ward door. There were indications that use of breath testing for alcohol might reduce usage and that the use of ‘sniffer’ dogs was associated with greater alcohol use.

Conclusion.  Greater exit security or locking of the ward door had no influence on rates of use of alcohol or illicit drugs by inpatients and thus cannot form part of any strategy to control substance use by inpatients. There are some grounds to believe that a greater use of screening might help reduce the frequency of alcohol/substance use on wards and may lead to a reduction in verbal abuse.

Publication Type: Article
Additional Information: This is the peer reviewed version of the following article: Simpson, A., Bowers, L., Haglund, K., Muir-Cochrane, E., Nijman, H. and Van Der Merwe, M. (2011), The relationship between substance use and exit security on psychiatric wards. Journal of Advanced Nursing, 67: 519–530, which has been published in final form at This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.
Publisher Keywords: drug monitoring/testing;dual diagnosis;locked doors;psychiatric inpatients;sniffer dogs;substance misuse;ward security
Subjects: R Medicine > RC Internal medicine > RC0321 Neuroscience. Biological psychiatry. Neuropsychiatry
R Medicine > RT Nursing
Departments: School of Health & Psychological Sciences > Nursing
SWORD Depositor:
Text - Accepted Version
Download (348kB) | Preview


Add to AnyAdd to TwitterAdd to FacebookAdd to LinkedinAdd to PinterestAdd to Email


Downloads per month over past year

View more statistics

Actions (login required)

Admin Login Admin Login