Urgent Adult Mental Health Crisis Referrals in England More Than Double in a Year
A recent report highlights significant increases in referrals to mental health crisis teams and ongoing issues within the care system.
Urgent adult referrals to mental health crisis teams in England have surged, more than doubling from 1,400 in April 2023 to 3,063 in March 2024, according to a report by the Care Quality Commission (CQC).
This increase has raised alarm among healthcare watchdogs, as it indicates that individuals are becoming increasingly unwell while awaiting assistance from overextended services.
The report reveals significant deficiencies in the system, including inadequate staffing and insufficient bed availability, leading ward managers to discharge patients who are described as the 'least unwell.'
The report further highlights a troubling trend regarding the detention of black individuals under the Mental Health Act, revealing that they are 3.5 times more likely to be detained compared to their white counterparts.
Dr. Sarah Hughes, Chief Executive of Mind, noted that black men face particularly high rates of overrepresentation in mental health crisis care, citing they are seven times more likely to be placed under community treatment orders, which are intended to prevent repeat hospitalizations.
Additionally, the report underscores disparities in access to mental health services, with individuals from the most deprived areas attending Accident & Emergency departments for mental health issues 3.5 times more frequently than those from affluent regions.
This trend suggests a correlation between socioeconomic status and mental health service utilization.
The CQC's findings are based on site visits to 870 wards and interviews with over 4,500 mental health patients.
It indicates that patients appear to be more unwell upon admission than in previous years.
Concurrently, the rising demand for inpatient care has resulted in premature discharges, complicating long-term recovery.
Among younger populations, nearly half of those detained under the Mental Health Act had to be readmitted within a year, suggesting a cycle of ineffective treatment.
Jenny Wilkes, interim director of mental health at the CQC, characterized this as a 'damaging cycle,' where inadequate access to timely care leads individuals to navigate a fragmented service landscape without receiving necessary support.
The CQC mentioned that proposed changes in the mental health legislation aim to curtail detentions and enhance patient care.
These changes, if enacted, would empower patients, involve relatives in discussions regarding care, and limit the duration for which individuals with learning difficulties or autism can be detained.
The report also notes a 25% increase in inappropriate out-of-area placements for treatment, escalating to approximately 5,500 patients being sent far from their homes.
Quality of care within wards has been critiqued, with many facilities reporting bed shortages that result in patients being placed in seclusion rooms not meant for long-term habitation.
Testimonies from various stakeholders highlight ongoing challenges within the system.
Marjorie Wallace, Chief Executive of the mental health charity SANE, reported that individuals seeking help are often informed about the unavailability of local beds, as crisis teams maintain full capacities.
Meanwhile, Hughes pointed to systemic issues such as inadequate staffing and outdated facilities that hinder recovery and dignity in care.
The chosen environment for treatment has also been called into question, with extreme cases noted, such as a 12-bed ward accommodating 16 individuals—forcing some patients to go without a designated bed.
Brian Dow, Deputy Chief Executive of Rethink Mental Illness, described the current state of the mental health system as 'at breaking point,' urging for a national plan to secure necessary funding and staff to provide timely mental health support.