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Call for evidence
‘ Mental health patients forced to travel miles’ and ‘Mental health patient put in police cell’ – these are a couple of headlines from the BBC News website in the last few months. This is not a new issue - statistics indicate a long term reduction in numbers of psychiatric hospital beds - around 140,000 in 1955, 64,000 in 1979, and now around 20,000 in England and Wales. So is there a beds crisis in mental health? The Royal College of Psychiatrists have set up a Commission on Acute Adult Psychiatric Care to find out and are calling for evidence from patients and their carers, health and social care organisations and professionals. The call for evidence closes on March 18th.
Better care at home?
So what’s the background to this? The reasons for the downward trend of beds has been the move to community care. This is a policy that has not been without difficulty or controversy, but many more people with severe mental health problems are now assessed and treated at home. There’s lots of mental health law to make that possible, including the use of Community Treatment Orders. It also reflects the general desire that it’s better to be at home, and services have been developed to support this, such as Community Mental Health teams and 24 hour crisis services. However, these services have been under pressure, and with a background of financial restraint, some of the expansion of teams such as assertive outreach and early intervention over the last 15 years has stopped. In fact, perversely the growth of more community teams has sometimes meant that awareness of new interventions for people with mental health problems has risen so that more and more people are being referred for in-patient care!
The shortage of hospital beds isn’t just an issue in mental health care. There’s been a lot of discussion recently about ‘bed-blocking’ in general hospitals. Some of the factors that are influencing the pressure on general beds may be affecting mental health admissions as well – the rising elderly population, and pressures on care at home alternatives.
Gathering the evidence
So there’s lots of anecdotal evidence of people struggling to get access to hospital beds, and in some really stretched areas, suggestions that you have to be detained under a section of the Mental Health Act before you get admitted. The pressure on crisis services means that alternatives to admission are often not around.
So if you’ve got views on the availability of beds, this is a chance to have an input. The call for evidence invites you to submit your views on the value of in-patient care, and invites examples on good and poor quality care, and community alternatives. You can read about the review into in-patient care here.
David Beckingham – QCS Expert Mental Health Contributor