Despite a government promise to end the practice, mental health patients are still being sent many miles from home for treatment
"It is shameful that mental health patients are being routinely let down by this government, who are now two years past their target of ending the practice of sending patients out of area for treatment by March 2021, and still failing miserably. This isolating and dehumanising practice is a direct consequence of a fragmented and underfunded mental health care system that has been letting patients down for far too long.” Dr Andrew Molodynski, health policy lead, British Medical Association
In the past two years, more than 5,000 mental health patients have been sent at least 62 miles, or 100km, from their home for treatment.
The analysis of NHS data by the Royal College of Psychiatrists found that 8,925 new “inappropriate” placements occurred between April 2021 and March this year. Of these, 5,335 involved a patient being sent more than 62 miles away, of whom 695 were sent to a mental health unit at least 300km (186 miles) away. One patient was taken 605km (378 miles) from their home in Plymouth, Devon to a residential psychiatric unit in Darlington, Durham.
Dr Adrian James, the College’s president, said “This unacceptable practice – sending patients hundreds of kilometres away from their homes and families – has likely been happening for decades. It risks patients’ mental health to such a degree that they often remain in hospital for longer.”
Seven years ago the government said they would end the practice of out-of-area placements, caused by a shortage of beds, by March 2021.
Dr Andrew Molodynski, a psychiatrist and health policy lead at the British Medical Association (BMA), said: “It is shameful that mental health patients are being routinely let down by this government, who are now two years past their target of ending the practice of sending patients out of area for treatment by March 2021, and still failing miserably. This isolating and dehumanising practice is a direct consequence of a fragmented and underfunded mental health care system that has been letting patients down for far too long.”
Mental health campaigners, psychiatrists and patients’ families have argued that being far from home can make already vulnerable patients feel isolated and reduce their chances of making a recovery.
“It’s appalling that the government have not brought an end to the scandal of out of area mental health placements, two years after the deadline they gave themselves for doing exactly that”, said Rosena Allin-Khan, the shadow cabinet minister for mental health. “Two years on, this is another disgraceful broken promise on the NHS, with patients suffering far away from their loved ones and support networks.”
The Royal College of Psychiatrists and the BMA have written to Maria Caulfield, the mental health minister, recommending a major expansion of community-based services to help reduce the number of people ending up in a mental health crisis and needing inpatient care. James said: “First and foremost, we need comprehensive community services to avoid admission wherever possible. We also need beds available locally when patients need admission. This is severely lacking in many areas.”
He also called for the urgent publication of the long-awaited NHS workforce plan, adding: “When patients require hospitalisation, it is vital that there are properly staffed inpatient wards, which depend on a robust mental health workforce. This is impossible without the long-awaited NHS Workforce Plan, which must be published urgently. If these placements continue it is ultimately patients who will pay the price.
“Patients should be offered effective alternatives to hospital admission so they can receive help earlier, from the right specialist, for their specific needs, instead of being sent out of area for treatment.”
Gemma Byrne, policy and campaigns manager at mental health charity Mind, said the figures demonstrated that the mental health care system was in need of a “complete overhaul,” adding: “Across the board, from community to acute care, services are struggling to keep pace with a nation in the grips of a mental health crisis.”
She said that it was “high time the UK Government made good on its promise to deliver a reformed Mental Health Bill, hand in hand with investment in early intervention and community care, as well as a statutory public inquiry into failings in mental health hospitals. It is time to raise the standard of mental health care.”
The government’s deadline for ending out-of-area mental health placement passed two years ago, but the problem continues. With demand for mental health services continuing to increase, the service is unable to cope. Mind is right to say that the government needs to address this both by improving community services, in order to reduce the need for acute care, and by publishing the long-overdue workforce plan to make sure the service is adequately staffed.