The restraints of the mental health unit made me feel unwell, said the Fishguard patient

Francesca Murphy was still in her school uniform when she was admitted to the adult mental health ward.

He was 18, still in school and very scared.

Mind Cymru said there were concerns about staff shortages, care planning and the use of restraints in mental health inpatient units across Wales.

The Welsh Government said it had invested £2m in improvements.

Ms Murphy, now 27, said her life changed dramatically after a boating accident in 2014.

She became trapped underneath her boat with a rope wrapped around her ankle after she capsized.

He was rescued and was physically fine, but it led to a rapid decline in his mental health, which led to him self-harming and attempting to take his own life.

He was admitted to the child and adolescent inpatient unit but was discharged back into the community the day before his 18th birthday.

Since then, he has spent time in various mental health inpatient units, both voluntarily and under section, across Wales and England.

Ms Murphy, from Fishguard in Pembrokeshire, said: “I was what you would refer to as a revolving door patient.”

He would go missing, before being picked up by police and temporarily hospitalized, before being discharged two days later.

“The circle will go round and round,” he added.

The longest time in hospital is between six and seven months.

Without the support she received from her psychotherapist she said she would not be here today.

However, he also spoke of several experiences in the hospital, where he was subjected to physical and pharmacological restraints, which were traumatic.

He was restrained in a face down position at least twice.

Restraint or restrictive practices should be a last resort and efforts should be made to calm the unstable situation beforehand.

“[It was] horrible. I had three men and one woman hold my four limbs and inject me and choke me, before telling me to get out of the situation,” he said.

“One time I remember, obviously I heard, ‘let’s take him to the room’.

“I’m still very much trying to get over the memories of the sailing incident and when something is around my ankle, it triggers everything that happened.

“That would make me even more unwell.”

Ms Murphy agreed that improvements were needed in mental health inpatient units.

She says consistency of care and clear communication are essential.

“If you’re going to say you’re going to do something, then do it. Don’t say you’re going to put something in place and then not follow through.

“I’m lucky to have amazing therapists who look at me holistically, and they work with my family … a lot of professionals wouldn’t talk to them,” she says.

He also cited a lack of eating disorder training in general psychiatric units.

Ms Murphy has now been discharged from mental health services and is working two jobs, coaching sailing and has returned to the water.

“I want to speak for people who are no longer here to defend.”

She contributed to a a new report by Mind Cymru which focuses on mental health inpatient wards in Wales.

Concerns were raised about staff shortages, lack of data and general care and safety.

The charity found 13 out of 18 hospitals reported problems arising from staff shortages in 2022-23 which negatively affected patients.

It also said that more detailed data collection is needed to provide a more complete picture of inpatient and restraint care, particularly regarding race and other protected characteristics to address inequality and discrimination.

It outlines a number of areas that need improvement, including the need to enforce stricter and legal practice laws in the UK.

Across borders, the Mental Health Unit (Use of Force) Act 2018 – known as the Law of the Arts – aims to protect patients from the use of disproportionate and inappropriate force.

In Wales, the guide is not valid.

Simon Jones, from Mind Cymru, said guidance in Wales was similar but should be a legal requirement.

“The statutory element adds legal protection and the data collected is more transparent, so we want to see that in Wales so we know exactly what’s going on,” he added.

The Welsh Government says improving the safety and quality of mental health is a priority.

He said it was reflected in a £2m investment to drive service improvements, which included the Mental Health Patient Safety Programme.

“We have recently consulted on our draft Mental Health and Wellbeing Strategy which has been developed in collaboration with a range of partners, including service users and carers, setting out our vision for improvement over the next 10 years,” he added.

If you, or someone you know, has been affected by mental health issues or self-harm, help and support is available BBC Action Line