A recent survey by the Royal College of Psychiatrists Trainees Committee (PTC) has revealed that some mental health patients are being sent home because of a lack of beds and some are being sectioned under the Mental Health Act in order to get a bed. Both practices are unacceptable.
Sent hundreds of miles away
Over 550 junior doctors responded to the survey and the results are quite disturbing.
70 percent had said they had experienced difficulty in finding a bed for a patient on at least one occasion and this figure was 83 percent for child and adolescent services. Around 80 percent had been forced to send a patient further afield in order to get a bed with 37 percent having to send a patient more than 100 miles away and 22 percent forced to send a child more than 200 miles away from home.
No bed unless sectioned
Almost a quarter of the trainees had been told by a bed manager that a patient would not get a bed unless they had been detained under the Mental Health Act and 37 percent of trainees said a colleague’s decision to detain a person was influenced by the fact that they would get a bed.
No one should be detained under the Mental Health Act unless they are a risk to themselves or to other people. There are strict procedures to follow for sectioning someone as it means an individual is being admitted to hospital whether they agree or not. The decision is made by an approved mental health professional and two doctors. The assessment can last up to 28 days and the treatment section for up to 6 months after which it can be renewed.
If patients are being detained just to get a bed or sent home when they need a bed then there is something seriously lacking in the provision of mental health care today and this needs to be resolved.
Demand for beds greater than supply
70 percent of trainees had experienced seeing a patient admitted despite a bed not being available and almost 30 percent had had to send a patient home because there was no bed for them.
These figures show that one thing is pretty clear; there is a greater demand for beds for mental health patients than there are beds available.
BBC News and Community Care have also carried out investigations into mental health provision and report that there are 1,700 fewer beds for mental health patients now than there were before and that some patients are being sent far away from their local area for treatment.
Dr Alex Langford, a trainee psychiatrist, said the survey highlights the extent of several practices occurring as a result of bed shortages.
“These practices signify serious risk to patients due to a crippling lack of resources. The fact that psychiatrists are having to consider sectioning patients to secure something as basic as a bed is a huge warning sign of extreme under provision. These doctors are using the only option they have left to ensure very unwell people get the care they desperately need.”
One person died
One trainee psychiatrist told the BBC that one person had died as a direct result of not getting a bed in the local area.
“The patient presented to us, they needed to be admitted, we couldn’t admit them locally, they were admitted to a hospital hundreds of miles away.
“The care they received was not what we’d have done and they died”.
These results are “very alarming” said Dr Howard Ryland who oversees psychiatric training.
President of the Royal College of Psychiatrists Professor Bailey describes the situation as “unacceptable”.
"Continued cuts to services can only result in further distress and discomfort for patients, many of whom are young, vulnerable, some of whom are forced to receive care far from home. This situation is simply not acceptable” said the professor.
Norman Lamb MP who was appointed Minister of State for Care and Support in 2012 recognises that the situation is critical.
“It is not acceptable to detain someone under the Mental Health Act purely because they need an inpatient bed” said Lamb.
“Decisions about detention must always be taken in the best interests of patients at risk of harming themselves or others.
“Inpatient beds must always be available for those who need them. We are scrutinising local NHS plans to make sure they put mental health on a par with physical health.”
£50m could be saved
According to mental health charity Rethink, mental health accounts for 23 percent of the disease burden in England yet receives only 13 percent of the budget.
Mental health trust budgets have also been cut but at the same time, referrals for mental health care are rising.
An earlier report published by Rethink and the London School of Economics, predicted that more than £50 million could be saved every year if mental health problems were detected earlier.
The report also highlighted that it costs £13 a day to support someone with schizophrenia in the community compared to £350 a day in hospital and the NHS saved £989 every time someone was treated with cognitive behaviour therapy instead of hospital.