Cuts to mental health services mean that
patients are being sent home in the absence of a bed – or being
sectioned to secure one, a survey by the Royal College of
Psychiatrists’ Psychiatric Trainees' Committee (PTC), has
The survey asked junior doctors working in
psychiatry in the UK to talk about their experiences of working in
mental health over the last six months.
Some 3,504 trainees were contacted across the
UK. Of the 576 trainees that responded: 70% said they had
experienced difficulty finding an appropriate bed for a patient at
least once. In child and adolescent services (CAMHS) that figure
- 80% had sent a patient outside the local area for a bed, 15%
doing this more than monthly.
- 37% had sent a patient at least 100 miles outside their local
area. Of those working in CAMHS, 22% had been forced to send a
child 200 miles away from their families.
- 37% said a colleague’s decision to detain a patient under the
Mental Health Act had been influenced by the fact that doing so
might make the provision of a bed more likely, and 18% said their
own decisions had been influenced in such a way.
- 24% reported that a bed manager had told them that unless their
patient had been sectioned they would not get a bed.
- 20% have admitted a patient to a bed belonging to a patient who
has been sent home on a period of trial leave.
- Three out of ten had seen a patient admitted to a ward without
a bed – presumably leaving them to camp on a sofa in a communal
- 28% have sent a critically unwell patient home because no bed
could be found.
The survey responses, which indicate that
demand for beds outstrips supply, build on findings by BBC news and Community Care
magazine in a joint investigation this month. Data obtained
from 30 of England’s 48 mental health trusts showed that overall
the number of patients sent out of area has more than doubled
between 2011-12 and 2013-14.
Dr Alex Langford, a trainee psychiatrist,
said: “This survey investigated for the first time the extent of
several practices which occur as a result of the bed crisis.
“These practices signify serious risk to
patients due to a crippling lack of resources. The fact that
psychiatrists are having to consider sectioning patients to secure
something as basic as a bed is a huge warning sign of extreme under
provision. These doctors are using the only option they have left
to ensure very unwell people get the care they desperately
“The survey shows just how pervasively
dangerous the disparity between resourcing in mental health and
other medical specialities is.”
Dr Howard Ryland, chair of the PTC said:
“Psychiatry is a highly rewarding profession, but the difficulties
highlighted by this survey demonstrate how challenging it can be to
work in mental health services currently. If these serious
shortcomings are not immediately addressed, it will become
increasingly difficult to recruit and retain the dedicated
psychiatrists our patients need.”
Professor Sue Bailey, president of the Royal
College of Psychiatrists said: “This survey provides further
evidence that mental health services are approaching a tipping
point. Continued cuts to services can only result in further
distress and discomfort for patients, many of whom are young,
vulnerable, some of whom are forced to receive care far from home.
This situation is simply not acceptable.”
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