Call for end to ‘inhumane’ practice of sending mental health patients far from home for treatment

The “inhumane” practice of sending mental health patients hundreds of miles away from home for treatment must end, the Royal College of Psychiatrists has said.

A failure to stop so-called inappropriate out-of-area placements has been branded “a scandal” by the college, adding the approach is costing the NHS millions of pounds each year which could be better spent.

A report in 2016 from the independent Mental Health Taskforce to the NHS in England stated that by 2020/21 out-of-area placements would essentially be eliminated for acute mental health care for adults.

The data, which relates only to acute mental health admissions among adults, also shows almost three-quarters (71%) of placements that ended over that time lasted for 15 or more nights, while 40% lasted for 31 or more nights, according to the college.

It said being far from home, and without friends and family able to visit, can leave patients feeling isolated and emotionally distressed with long-lasting consequences for their mental health.

The college said the health service spent £102 million on inappropriate out-of-area placements last year, adding that was equivalent to the cost of the annual salary of over 900 consultant psychiatrists.

A lack of properly staffed beds or alternative specialist intensive provision locally are contributing factors to the continuation of the practice, the college said.

Dr Adrian James (pictured), college president, said: “The failure to eliminate inappropriate out-of-area placements is a scandal. It is inhumane and is costing the NHS millions of pounds each year that could be spent helping patients get better.

“No-one with a mental illness should have to travel hundreds of miles away from home to get the treatment they desperately need. The health and social care system, both on a national and local level, must urgently come together and make sure no-one ever has to.

“We need to understand what is driving this unacceptable practice in different parts of the country and invest in local, properly staffed beds, alternatives to admission, and follow-up care in the community. Central to this is Government backing to address the workforce crisis that continues to plague mental health services.”

Sean Duggan chief executive of the NHS Confederation’s Mental Health Network, said the NHS is “contending with a rise in demand for people requiring support for their mental health against a backdrop of fewer dedicated beds”.

He said health leaders “continue to be dismayed that of the 48 new hospital building projects promised by the Government, only two are for mental healthcare”.

He called for the NHS to be given “the staff and estates it needs to get progress on eradicating ou-of-area placements back on track”.

He added: “Mental health providers want more honesty and transparency about the problem, which a new target for eradicating out of area placements could facilitate.”

Tom Quinn, from UK eating disorder charity Beat, said: “It’s unacceptable that people are still being sent miles away from home for mental health treatment, over a year since the Government pledged to end this inappropriate practice.”

He called on the Government and NHS England to “develop a fully-funded mental health recovery plan”, to include “addressing gaps in the workforce and ensuring that frontline staff have the resources they need to help every patient”.

The Department of Health and Social Care said Covid-related pressures had contributed to services missing the 2021 target.

A spokeswoman said: “Everyone should have access to safe, appropriate mental health care and we recognise the impact that receiving care far away from loved ones can have.

“That’s why we are investing an extra £2.3 billion per year to transform NHS mental health services by 2024, meaning more people will be able to receive care as close to home as possible.”

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