People with mental ill health had almost five times more emergency hospital admissions last year relative to people without – yet most were not explicitly linked to their mental health needs, a study has found.
In addition, the study, published by the Nuffield Trust and the Health Foundation, found that a proportion of these emergency admissions were potentially preventable. It suggests that people with mental ill health are not having their physical health adequately managed, despite being known to the NHS for their mental health needs.
Drawing on analysis of more than 100 million hospital records per year, the research compared hospital use between two patient groups: people who have previously been to hospital for their mental health and those whose previous hospital use does not relate to mental health. The analysis looked at patterns of emergency and planned hospital use between 2009/10 and 2013/14.
The study found that:
• People with mental ill health experienced 4.9 times more emergency hospital admissions and 3.2 times more A&E attendances than people without in 2013/14
• Despite previous experience of mental ill health, only a fifth of the emergency hospital admissions this group experienced in 2013/14 were explicitly for mental health needs
• People with mental ill health had 3.6 times more potentially preventable emergency admissions than those without but slightly fewer planned inpatient admissions
• For some common physical health procedures, people with mental ill health were more likely to have an emergency rather than planned admission, stay longer in hospital or be admitted overnight. For example, for people with mental ill health who had a hip replacement, 40% experienced an emergency rather than planned admission; whereas for people without mental ill health, just 8% of these admissions were an emergency.
“It is striking that people with mental ill health use so much more emergency care than people without, and that so much of this isn’t directly related to their mental health needs,” said Holly Dorning, research analyst at the Nuffield Trust. “This raises serious questions about how well their other health concerns are being managed. It is clear that if we continue to treat mental health in isolation, we will miss essential care needs for these patients.”
Felicity Dormon, senior policy fellow at the Health Foundation, added: “It is deeply unfair that the physical health needs of people with mental health problems continue to be poorly met. Some areas are trialling innovative approaches to tackling this pressing issue, but these approaches are not widespread. The challenge for national policy makers and local leaders is to find the will and resource to support this innovation and improve care at scale and pace.”
Nigel Edwards, chief executive at the Nuffield Trust, said: “The higher rates of unplanned and preventable emergency admissions experienced by people with mental ill health are of national concern. But with austerity affecting both local authority and NHS mental health services, achieving parity of esteem between mental and physical health may remain an aspiration rather than a reality.”
The Nuffield Trust and Heath Foundation study is published as part of their five-year QualityWatch programme. It offers a new way to measure progress towards parity of esteem between mental and physical health, a policy goal of all major political parties.