Emergency mental health admissions delayed up to 3 weeks due to beds crisis, social workers warn

Shortage of mental health beds at time of rising demand leading to delays that damage patients and placing AMHPs in “intolerable” positions, warns College

Mentally ill people assessed by professionals as needing urgent hospital care are having to wait up to three weeks for admission due to a shortage of NHS mental health beds, a survey of approved mental health professionals (AMHPs) has revealed.

The College of Social Work warned that AMHPs are being placed in “intolerable” situations after eight in 10 AMHP leads surveyed said that bed shortages had led to delays, in one case of 21 days, in admissions for people who had been assessed “as needing immediate” hospital care under the Mental Health Act.

“Delays to admission were considered by all respondents to result in increased risk to both the individual and others,” said the survey, which also found that two-thirds of AMHP leads had delayed Mental Health Act assessments due to bed shortages.

Around 2,000 mental health beds were closed in 2011/12, according to a ‘rough’ estimate in NHS figures released in February. The Care Quality Commission has warned that the shortage is placing “services and patients under stress”.

The survey, of over 100 AMHP leads from across England, also revealed that 90% of AMHPs had seen patients forced to travel out-of-area due to bed shortages – an issue raised by a recent Community Care investigation.

The research also raised concerns over police and ambulance support. Almost two-thirds of AMHPs had postponed Mental Health Act assessments at least twice in the last six months due to a lack of police availability, while just four in 10 respondents felt that local ambulance support worked well.

Over three-quarters of AMHPs (78%) said that bed shortages had resulted in people being detained in A&E departments or, most commonly, police cells for “a significant period”. More than half (59 per cent) reported at least one incident when this delay was over 24 hours.

A number of respondents (16.5%) said that hospitals’ refusal to accept ‘informal admissions’ had left AMHPs feeling forced to detain the person under the Act.

“This is a potentially worrying finding as it suggests that in a small number of cases a person’s liberty may be being restricted for reasons other than for the individual’s ‘health, safety, or protection of others’ as per the MHA criteria for formal detention,” the College’s report said.

Dr Ruth Allen, chair of The College of Social Work’s mental health faculty, said that mental health crises were not being “treated on a par” with other acute healthcare 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,” said Allen.

“This sometimes leaves AMHPs in intolerable situations, struggling to discharge their statutory functions,” she added.

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