Mental health in England is a national emergency, say hospital bosses
NHS Confederation says mental health has slipped down the priority list and patients are being forgotten
Mental health care in England has become a “national emergency”, with “overwhelmed” services unable to cope with a huge post-Covid surge in people needing help, NHS bosses have said.
Care is so stretched that thousands of people in mental health crisis are admitted to acute hospitals every year, even though they are not set up to deal with them.
Hospital bosses claim that mental health in England has been “forgotten” by ministers who have prioritised tackling a record 7.7 million care backlog, access to GPs and ongoing NHS strikes.
“Mental health has slipped down the government’s list of priorities and patients and services are being forgotten. This is a national emergency that is now having serious consequences across the board, not least for patients in crisis,” said Matthew Taylor, chief executive of the NHS Confederation.
Evidence collected by the Confederation from NHS trusts in England shows that some mental health patients are in such poor health that they have to be admitted to acute hospitals because there are no beds available for them in specialist mental health facilities, or other help available.
“People are coming to A&E and having to wait very long periods of time to either be admitted or to find the right package of care for their needs in the community,” Taylor added.
“NHS leaders say this is now leading to thousands of patients being admitted to acute beds when this may not be the right clinical setting for them, and risks further deterioration in their mental health as a result.”
A historic lack of investment in community mental health facilities and supported housing places means that “there is simply nowhere else for people to be referred to quickly enough, at which point the only viable option is admission to an acute bed,” Taylor added.
People in the midst of a mental health crisis spend up to 50 hours stuck in A&E because NHS support for them outside of hospital is so limited, the confederation said.
However, acute hospital bosses expressed concern that their doctors, nurses and other staff were not well placed to respond to all the needs of people suffering from severe episodes of illness, such as depression or psychosis, because their expertise was primarily in managing physical illness.
One acute manager said: “We often reach a point where the whole [health] system agrees that the acute hospital is not the right place for the patient, but finding a better place is a huge challenge.
“The impact this has on the patient themselves, the staff caring for them and the other patients on the ward cannot be underestimated.
“The patient is being cared for physically, but their mental health often does not improve and can deteriorate in the noisy environment of an acute hospital ward.”
The Confederation’s intervention comes after NHS England’s national director for mental health admitted that services are severely understaffed and that psychiatric hospitals are consistently close to full due to unprecedented demand for care.
“Many services are still struggling with staffing levels,” Claire Murdoch told the Health Service Journal. One in five mental health nursing posts are vacant. In addition, mental health trusts rely on locum doctors more than any other area of NHS care, according to evidence gathered by the University of Manchester and shared with the HSJ.
Murdoch, who worked as a mental health nurse and runs a major London mental health trust, also said that the long delays patients face in accessing care meant that ‘the treatment gap is still too wide’.
NHS England has delayed the introduction of new mental health waiting time targets for two years amid fears that staff shortages mean they cannot be met.
A Department of Health and Social Care spokesman said: “We are transforming our country’s mental health services, investing an extra £2.3bn a year to expand services so that an additional 2 million people can get support.” The £2.3bn funding was announced in 2019, before the pandemic put extra pressure on mental health services.
“Our workforce plan sets out an ambition to increase the mental health workforce by 73% and by December 2022 there will be 9,000 more mental health staff than the previous year,” it said.
