Social workers alert Hunt to dangers of mental health bed shortage

A group of approved mental health professionals has issued a direct plea to Jeremy Hunt to address failings in mental health provision it says are placing vulnerable patients and families at risk.

In a letter to the health secretary, the Yorkshire AMHP leads network warned a shortage of mental health beds meant some patients assessed as needing to be detained under the Mental Health Act for their own safety, or that of others, were being forced to wait days to get hospital care.

The group said some patients had been held in A&E departments, police stations or care homes until a bed became available, but others were left at home relying on families or friends to manage their “acute mental health crisis”.

“We are asking you to give the situation your immediate and highest priority before any more patients and their families have to experience this very distressing and potentially dangerous situation again,” the group’s letter said.

Andy Brammer, a member of the Yorkshire AMHP leads network, said the group raised its concerns with Hunt in March but had yet to receive a reply.

A Department of Health spokesperson said Hunt had sent a response to the group’s concerns on March 31. The spokesperson said the government was investing in mental health services to make sure the right support was in place.

Speaking to Community Care yesterday, Brammer said the issues raised in the letter remained “live” and AMHPs still often faced “significant delays” securing beds for people in crisis.

“There is a lot of consideration that goes into detaining someone under the Mental Health Act. It is a last resort. People being detained are often those at most risk to themselves or others, and in the greatest level of distress,” he said.

“To have that detention delayed for hours, or even days, just increases that level of distress for the person and their family. It’s very stressful for workers as well who are having to manage the situation.”

Brammer added: “Previously AMHPs were waiting hours for beds to become available in virtually all circumstances. Then we saw it shifting to waiting 24 or 48 hours, and that tended to be with people who were in places like A&E – it wasn’t ideal but at least they were somewhere safe.

“We’re now looking at people being in their own homes and being left with a phone line for services. It’s an invidious position for everyone involved.”

Ruth Allen, chief executive of the British Association of Social Workers, said the concerns raised by the Yorkshire AMHPs echoed those raised by practitioners in other parts of the country.

“The feedback we get from AMHPs is that the bed situation has not been resolved in most areas,” she said.

“The focus on improving mental health crisis services, through the government’s crisis care concordat policy, does not appear to have led to better preventative resources for people to avoid admissions or opened up pathways into beds when they are most needed.”

Figures published last month revealed almost 6,000 mental health patients were sent out of their local areas for care last year due to no beds being available locally. This marked a rise of 40% over two years. NHS England has pledged to end inappropriate out-of-area admissions by 2021.

An investigation by Community Care and BBC News published in 2014 found seven suicides and one homicide had been linked to mental health bed shortages over the previous two years.

In December 2013, Nigel Meadows, senior coroner in Manchester, alerted Hunt and NHS England to problems with bed availability following the suicide of a patient who had been assessed as needing ‘urgent admission’ but faced an eight day wait for care.

A Department of Health spokesperson said: “We are clear that inpatient services should be available for all who need them. Decisions about bed numbers are based on a local assessment of need. We are making sure the right services can be put in place, with annual spending on mental health services increasing, now at more than £11 billion.

“In addition, getting community support right is vital, that’s why we are investing £400m a year by 2020 to expand the Crisis Resolution Home Treatment teams which will help open up in-patient beds.”