People with urgent mental health conditions are being detained for too long in police cells and at hospital accident and emergency units due to a shortage of specialised services and support, a survey of approved mental health professional (AMHPs) lead officers in England has claimed.
These delays in access to treatment are causing a significant risk to these people and, to a lesser degree, others who are in contact with them, the survey also reported.
More than 100 AMHP leads from the 152 local authorities in England responded to the survey by the College of Social Work to gauge the current state of access to mental health services for people in crisis. More than 80% of respondents reported that in the past 6 months they knew of an urgent compulsory hospital admission being delayed due to difficulties in finding an available hospital bed, with 41% saying they had experienced this more than 5 occasions.
The leads revealed that AMHPs had to detain people under the Mental Health Act (MHA) because an informal voluntary admission was not available at the time of the assessment and the person’s needs were such that the only appropriate intervention was an admission to hospital by whatever means possible. Sixteen per cent of respondents admitted resorting to this at least once in the last 6 months.
In addition, 73% of respondents said in the same period at least 1 MHA assessment had been postponed due to a lack of available police support with 29% reporting that this had happened more than 5 times. Similarly, availability of ambulance support to transport individuals to hospital where this was needed was raised as an area of concern as it resulted in additional delays.
In all, 78% said they experienced people in a mental health crisis being kept in police cells or hospital accident and emergency units for more than 4 hours due to the lack of suitable beds, with 59% reporting at least one incident when the delay was for more than 24 hours.
The AMHP leads said delays and blockages across the mental health system are resulting in an increased risk to the health of individuals experiencing mental distress, their family members, carers and care professionals that support them in addition to people in the wider community.
Dr Ruth Allen, chair of The College of Social Work’s mental health faculty, said: “This survey shows that mental health crises are not being treated on a par with other acute health crises. Waiting long times for ambulances, waiting in police cells and not being offered an alternative to being detained under the Mental Health Act are all signs of a system that is not coping and cannot protect people's rights effectively. This sometimes leaves AMHPs in intolerable situations, struggling to discharge their statutory functions.
“Taken with the national data showing year-on-year increases in detention rates, the survey shows we are not doing enough to prevent crises, respond well when they do happen and support service users and their families in the community.”