CQC in warning over lack of mental health support

By The Press Association22nd October 2014News EnglandCare Quality Commission, Mental Health, News Scotland

Too many mentally-ill people are still ending up in police cells because of a lack of adequate specialist places and staff shortages, a watchdog warned, with some even being denied medical attention simply for being young or drunk.

The Care Quality Commission (CQC) said there would be a “national outcry” if patients suffering a physical health emergency were turned away from hospitals or other health units in the same way as those being detained under the Mental Health Act.

Yet a survey of so-called “health-based places of safety” found significant inadequacies that needed to be addressed, including policies of deliberately excluding young people and those intoxicated or displaying disturbed behaviour.

The CQC called for a co-ordinated analysis of where gaps exist, urgent action to deploy sufficient trained staff to each facility to receive people in need of help and efforts to ensure “appropriate and timely” ambulance arrangements for transporting people experiencing a crisis.

Anyone detained by the police under the legislation must be taken immediately to a safe place where a mental health assessment can be undertaken, such as units contained in mental health hospitals or emergency departments at general hospitals.

Police cells are supposed only to be used as a last resort.

But a quarter of providers told the CQC that they did not believe that provision of safe facilities was adequate and research also exposed a perceived lack of oversight and data about the issue.

Dr Paul Lelliott, deputy chief inspector of hospitals at the CQC, said “a great deal of work” had begun since the survey to address the problems it exposed but there was “still more to do”.

“What our survey of health-based places of safety found is not good enough,” he said.

“There would be a national outcry if people experiencing a physical health crisis were treated in the same way. Imagine if people who had had a heart attack or stroke, were regularly turned away from an A&E department due to a lack of staff or beds, or if people who had been seriously injured in an accident or attacked were told they couldn’t receive care because they had been drinking or were showing signs of being disturbed.

“We have found that people experiencing a mental health crisis are far more likely to end up in a police cell if a health-based place of safety is not available due to staffing or capacity problems, or has restrictions on access in place.

“Police are left with no option but to take a person to the police station, which is unacceptable and likely to cause additional distress to an individual who is already in a vulnerable situation.

“To give praise where it is due, we did find a number of providers with appropriate provision who were able to deliver a good service.

“We hope that those providers and their commissioners who were restricting access or not delivering as good a service will learn from those that are giving people the support that they need.

“The issues we have identified around access to health-based places of safety show why it is so important that parity of esteem is achieved between physical and mental health.

Home Secretary Theresa May said: “Too many people detained by the police under the Mental Health Act end up in police cells instead of in proper healthcare.

“This wastes police time and leaves those with mental health problems without the care and support they need.

“We must never accept a situation when a person in crisis is denied care because a health-based place of safety is full or unstaffed, or just because the person is intoxicated.

“This kind of exclusion is not consistent with the Crisis Care Concordat we launched with the Department of Health in February this year.

“The Home Office and Department of Health are already conducting a review into the use of police powers under the Mental Health Act, which will report shortly, and tomorrow I will host a joint summit with Black Mental Health UK on policing and vulnerable people.

“I call upon local health leaders, commissioners and providers to build on these efforts and use the CQC’s findings as a prompt to improve care for those that need it.”

Care minister Norman Lamb said: “It’s essential that people in crisis get urgent, compassionate care. That’s why I launched the Crisis Care Concordat and I’m grateful to the CQC for its valuable work to help drive up standards.

“We are seeing a reduction in the use of police cells as places of safety across the country but there is still work to do. I urge every area to sign a crisis care declaration by the end of the year because everyone, no matter their age, postcode or circumstances, should get high quality care when they need it.”