Ministers under fire over breaking of mental health crisis pledge in England

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Ministers under fire over breaking of mental health crisis pledge in England

Target to end ‘inappropriate’ out-of-area placements by April 2021 due to lack of beds has not been met

Health policy editor

Last modified on Wed 29 Sep 2021 05.40 EDT

Ministers are under fire for breaking a key pledge on mental health after statistics showed that hundreds of patients are being sent far from home every month because of a beds crisis.

The government pledged to end “inappropriate” out-of-area placements in mental health for adults in England – those caused by a lack of beds in treatment units near the person’s home – by April this year.

However, figures show that 695 people were sent out of area in April. The figure includes “inappropriate” placements and those deemed “appropriate” because the patient needed specialist psychological or psychiatric help that is only available in a few units. A large majority of placements have always been “inappropriate” because they are caused by a lack of beds.

The new figures come as the Labour leader, Keir Starmer, prepares to make his first “in-person” conference speech that will put addressing Britain’s mental health crisis at the heart of his pitch to voters.

Starmer will call mental health “one of the urgent needs of our time”, and promise that a Labour government will tackle it on a number of fronts.

Labour’s shadow health secretary, Jonathan Ashworth, obtained the figures from the Department of Health and Social Care (DHSC) in a parliamentary question. He criticised the government for failing to end a practice which psychiatrists and mental health charities say is a scandal that is “harmful and destructive” for vulnerable people in a mental health crisis and makes it harder for them to see their loved ones.

“The Tories promised to end this practice. But the reality is a decade of underfunding and bed cuts has had a devastating impact on mental health services, forcing more patients to be sent miles from home and placing a burden on them and their loved ones,” said Ashworth. “Tory ministers continue to fail mental health patients.”

In all 7,040 out of area placements were started in England between April 2020 and this April, the figures show. There were 645 in October 2020 and 600 in August last year.

During those 13 months, 175 placements of either kind involved patients being sent between 100km and 200km from their home area, 135 involved distances between 200km and 300km and in 45 cases the person ended up 300km or more away.

Out-of-area placements are “disastrous” for patients and their families, the Royal College of Psychiatrists said.

“Being treated far from home, sometimes hundreds of miles away, because the right bed isn’t available locally is disastrous for patients and their loved ones. It’s extremely disappointing that the target for eliminating inappropriate out of area placements hasn’t been met”, said Dr Trudi Seneviratne, the college’s registrar.

Mental health services are under extra pressure because Covid has left more people in a state of crisis and social distancing in residential units has reduced the supply of beds, she added. “The government must urgently invest in additional beds in the area that need them most and maintain funding for post-discharge support,” she added.

Out-of-area placements have persisted despite the huge concern around them, while the NHS has continued to cut its supply of mental health beds, which have fallen by a quarter since 2010, Labour revealed in July.

The mental health charity Mind said having to be treated in a bed away from home damaged patients’ chances of recovering from the deterioration in their psychological state.

“The UK government and NHS target to end the scandalous practice of sending mental health patients miles from home for treatment by this year has been completely missed.

“Crucially, these are not just statistics. Each one is a person who, at their most vulnerable, is sometimes forced to travel hundreds of miles from their friends and family to receive treatment,” said Vicki Nash, Mind’s head of policy, campaigns and public affairs.

“This is devastating for people’s recovery, particularly for children and young people, and makes no sense for the NHS or the taxpayer.”

She called for an expansion of community-based mental health support to help ensure that people needing urgent help get it rather than ending up in A&E or in an out of area placement.

The DHSC spokesperson said: “It is completely unacceptable for patients to be sent far away from their loved ones for treatment and we have committed to end inappropriate out of area placements.” The spokesperson gave no indication when the practice would end.

It has published a mental health recovery action plan to help services cope with the increased demand for care created by the pandemic and given NHS England GBP500m to fund that.

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