Royal College of Psychiatrists slams A&E mental health services

Patients with mental health problems receive poor services in accident and emergency wards, according to the Royal College of Psychiatrists.

In a critical report, the RCP says the “extremely variable” standard of assessment and management of mental health problems in A&E departments is of “grave concern”.

All emergency staff, including paramedics, GPs and paediatric staff, should be trained to carry out mental health assessments, the report says, while access to consultant psychiatrists should be improved to the same level as consultants specialising in physical health.

A lack of training and staff means A and E departments are failing to deliver psychiatric support for patients who have self-harmed or attempted suicide, which is one of the top five causes of admissions.

Compared with the treatment of people with physical health problems, the authors say the failings within the service model are nothing short of discrimination.

The report, written by an expert panel led by Professor Sheila Hollins, concluded that mental health was being viewed by some commissioners as a “low priority”.

It made an urgent plea for the development of “multi-disciplinary psychiatry services in all acute hospitals, working in collaboration with mental health crisis teams”.

The role of liaison psychiatry services should be expanded to make necessary referrals and co-ordinate professionals such as mental health nurses, who suffer from high burn-out and turnover rates, and general psychiatric teams, who are often not on site and slow to respond.

The review was carried out by the RCP in partnership with the Royal College of Physicians of London, the Royal College of Nursing and the College of Emergency Medicine.

Professor Dame Carol Black, chair of the Academy of Medical Royal Colleges, which endorsed the report, said: “It is a matter of shame that this document is needed.”

She added: “It is usually very difficult to have every specialised element to hand even in large acute hospitals, or for non-specialist staff to be in a position to call in specialist help. That is why acute psychiatric liaison services are an essential part of a whole acute service.”

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