A recent survey of 576 trainees working in psychiatry services across the UK has revealed that the loss of 1,700 hospital beds following cut-backs in mental health services has resulted in critically-ill patients either being sent home or sectioned under the Mental Health Act just so that “the provision of a bed is more likely”. The Royal College of Psychiatrists, which conducted the survey, said that the findings indicated that mental health services were approaching a "tipping point" and that the situation was "simply unacceptable”. The College has condemned the NHS for these cut-backs, stating that in-patient beds must always be available to those who need them and advocating that mental health services are on par with physical health.
The survey also revealed that a quarter of the trainees questioned had been told by their manager that, unless their patient had been sectioned, they would not get a bed. Unsurprisingly, the suggestion of detaining a patient under the Mental Health Act purely because they need an inpatient bed has been condemned by the College as it has stated that any “decisions about detention must always be taken in the best interests of patients (whom are) at risk of harming themselves or others”.
Sadly, as a consequence of the lack of resources and hospital beds, just under one third of the trainees said that they have had no choice but to send a critically-ill patient home without receiving the treatment they need. The alternative is to try to secure a bed at another hospital which can be up to 200 miles away which can cause further distress and harm to already very vulnerable patients if they are forced to receive treatment so far from home.
Naomi Holland, an associate within the clinical negligence team at Penningtons Manches LLP, confirms how significantly these cut-backs affect patients and says: “This survey further endorses what we already know about the significant pressures on the resources and the front line staff in mental health services. It is crucial that these vulnerable patients receive the appropriate care and support they need and that they are not unnecessarily detained or simply sent away. We have several cases at present where hospitals are unable to deal with mental and physical health aspects in the same place – and that inability results in a real compromise to the care provided in one respect – sometimes with fatal consequences.
“We have just concluded an inquest in a case where an elderly patient was send to a psychiatric ward because of the lack of mental health facilities in one hospital. However, because of the lack of proper medical assessment and follow up, she later died of pulmonary embolisms. Although the signs were there to be seen, they were not detected because of the lack of medical care. In that case, the coroner has made a recommendation to the Secretary of State about this issue but this is just one example of patient care being compromised by lack of mental health resources.”