Most NHS Trusts have no out-of-area placements but clinical lead expects ‘big rise’ in PTSD

The number of patients with mental health needs who have been shipped miles away from their homes for care has diminished during the Covid-19 crisis.

So-called “out-of-area placements” have previously drawn significant controversy, with some patients sent hundreds of miles away from their homes for support.

Professor Tim Kendall, national clinical director for mental health at NHS England, said the vast majority of NHS trusts have “no out-of-area admissions”.

But he said the pandemic is affecting people’s mental health, particularly with anxiety disorders and obsessive compulsive disorders (OCD).

Health workers are “gearing up” to provide care and have been told to be “assertive”, particularly when it comes to children’s mental health needs, he told a Royal Society of Medicine briefing on Covid-19.

Meanwhile, officials have taken note of huge surges in people seeking support for domestic violence as well as increases in the number of calls to Childline.

Prof Kendall (pictured) told the briefing: “There’s no doubt that most of the surveys that are currently being done around Covid and mental health are saying that it’s affecting people’s mental health in broad terms and especially for anxiety and anxiety-related conditions, including, interestingly, OCD.”

He added that officials expect a “big rise” in cases of post traumatic stress disorder (PTSD), which is quite common among patients who have needed treatment in intensive care units, and are anticipating increases in people with more severe mental health problems like psychosis.

Prof Kendall continued: “What we would expect is that you get a rise in people coming in to acute mental health.

“And as you probably are aware there’s been a drop in the use of the Mental Health Act, a drop in the use of inpatient admissions.

“In fact, so much so, that we’ve had one incredibly positive result in this – that the vast majority of places have now got no out-of-area admissions, because they’ve got so many beds.”

He said that there is not hard data yet on how the pandemic has impacted the mental health of the nation but added: “We have got some quite important evidence around domestic violence – [there has been a] 350% increase in general, online domestic violence searches on the internet.

“We got about a 50% increase in Childline referrals.

“I actually think that, you know, the whole sort of thing around children is a real concern. So, I hear of parents really struggling with education at home, really struggling with kids who’ve got neuro-developmental problems – ADHD and autism, that these kids are under stress.”

Professor Ed Bullmore, head of the Department of Psychiatry at the University of Cambridge said Covid-19 is an illness which needs to be taken “very seriously” from a psychiatric and neurological perspective for “months and years to come”.

He told the briefing: “A recent publication looked back at all the reports of psychiatric disorders following Sars or Mers.

“Up to 12 years of follow up after the acute illness, there we’re finding quite high frequencies of PTSD, depression, anxiety, insomnia, some mild cognitive impairment, perhaps the so-called Dysxecutive syndrome seems to be quite frequently reported as a sort of longer-term outcome.”

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