With more research this week pointing to a growing crisis in inpatient mental health services, the effects of austerity and cuts to services are becoming ever moreclear and are having a demonstrably adverse effect.
The Royal College of Psychiatrists’ Psychiatric Trainees' Committee’s survey made for grim, but unsurprising reading this week.
In the survey, 576 junior doctors working in psychiatry spoke about their experiences of working in mental health services over the past 6 months. Of those, 70% said they had experienced difficulty finding an appropriate bed for a patient at least once. In child and adolescent services that figure rose to 83%.
Additionally, 37% said a colleague’s decision to detain a patient under the Mental Health Act had been influenced by the fact that doing so might make the provision of a bed more likely, and 18% said their own decisions had been influenced in such a way.
Meanwhile, 24% reported that a bed manager had told them that unless their patient had been sectioned, they would not get a bed. Professor Sue Bailey, president of the Royal College of Psychiatrists, said the service was approaching a “tipping point”.
This all adds to the growing body of evidence that indicates to a developing crisis in inpatient mental health services. For instance, recent research by the BBC and Community Care has suggested that the number of people being sent out of area for treatment has doubled in the past two years.
It should be remembered that, behind these statistics, are people who, when they are at their most vulnerable, are not getting the right treatment at the right time and, increasingly, not in the right place either, as the number being sent out-of-area continues to rise. The consequences of these situations can be far-reaching: being denied treatment can lead to people experiencing much greater distress and requiring more acute, longer and expensive – bean-counters take note – treatment.
Care Services Minister Norman Lamb’s response to the research was as you would expect. He said it was not acceptable – something he seems to be saying a lot these days – to detain someone under the Mental Health Act purely because they need an inpatient bed. That is certainly true.
"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,” he added.
My instant reaction is ‘well, more people would have access to an inpatient bed if 1,700 of them hadn’t been closed in the past two years.’ [as BBC and Community Care research revealed last year]
Lamb’s comments don’t fill me with confidence that the situation is going to be effectively addressed any time soon. Yes, mental health needs to be put on a par with physical health, but that is a distant goal.
What’s lacking is a clear commitment to action on this. How many ‘wake-up calls’ does the government needs before it is prompted to do something?
Mental health services continue to be under-resourced and the consequences of the cumulative cuts made over the past few years – mental health funding is said to have declined by 2.3% in the past two years – are now becoming clear. What is more worrying is that further cuts are planned for the next few years at least, as clearing the government deficit is taking much longer than first anticipated. With mental health undoubtedly still in the line of fire for cuts, this can only make the situation worse.
As I have said before, throwing money at the sector is not a panacea, but it will help to address some problems. Reversing the cuts in inpatient beds must be a priority for this government – and before the general election next year – because otherwise they will lead to tragedies.
This doesn’t happen in physical health: nobody with an emergency condition such as a heart attack or broken leg is turned away from hospital because there isn’t a bed for them. That those with mental ill health who require care are being denied a bed should be a source of shame for the government.