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Psychiatrists see alarming rise in patients needing urgent and emergency care and forecast a 'tsunami' of mental illness

May 15, 2020, 23:01 PM by RCPsych Press Office
Mental health services are dealing with a rise in urgent and emergency cases but also preparing for a ‘tsunami’ of mental illness still to come, according to the Royal College of Psychiatrists.
  • 43% of psychiatrists have seen an increase in urgent and emergency cases following the COVID-19 lockdown.
  • At the same time, 45% of psychiatrists have seen a fall in their most routine appointments, leading to fears of a ‘tsunami’ of mental illness after the pandemic.
  • Psychiatrists are alarmed by both the drop-off in routine work, especially in CAMHS and old age psychiatry, and by the increase in urgent cases.
  • RCPsych is calling for investment in mental health services to be prioritised to enable services to cope with a surge in mental health cases after the COVID-19 peak is passed.

Mental health services are dealing with a rise in urgent and emergency cases but also preparing for a ‘tsunami’ of mental illness still to come, according to the Royal College of Psychiatrists.

A new survey of over 1,300 mental health doctors from across the UK reveals that 43% of psychiatrists have seen an increase in their urgent and emergency caseload while 45% have seen a reduction in their most routine appointments. Read a summary of survey responses. 

Psychiatrists are concerned that many patients are staying away from mental health services until they reach a crisis point. The pandemic has also made it much harder for services to offer routine appointments despite rapid adoption of new ways of working such as remote consultations and social distancing.

With referrals and regular appointments falling, those who are being treated are often those with the most serious conditions or presenting in crisis. This is at a time when the Office of National Statistics has found that almost half of the population of Great Britain (49.6%) has reported high levels of anxiety. Steps need to be taken so that mental health services are ready to help everyone who needs them now and following the initial peak in COVID-19 cases.

Professor Wendy Burn, President of the Royal College of Psychiatrists said: “We are already seeing the devastating impact of COVID-19 on mental health with more people in crisis. But we are just as worried about the people who need help now but aren’t getting it. Our fear is that the lockdown is storing up problems which could then lead to a tsunami of referrals.

“Mental health services will be at risk of being overwhelmed unless we see continued investment.”

The survey results suggest that the biggest drop-offs in routine care have been in mental health services for older adults, for children and young people, and within general hospitals. This is raising concerns that self-isolation and shielding, school closures and fear of hospitals are impacting on the numbers of patients accessing treatment for mental health.

The biggest rises in urgent and emergency cases have been for psychiatrists working with adults and those working in general hospitals

Dr Amanda Thompsell, Chair of the Faculty of Old Age Psychiatry, said: “We are worried about the impact of shielding and self-isolation, anxiety about the virus and the difficulty some older people find in using technology to video-call a doctor. Older people are often reluctant to seek help and their need for mental health support is likely to be greater than ever.”

Written responses to the survey from psychiatrists included:

  • “In old age psychiatry our patients appear to have evaporated, I think people are too fearful to seek help.”
  • “The admitted patients have more severe psychotic symptoms which incorporate COVID related themes.”
  • “Many of our patients have deteriorated/developed mental disorders as a direct result of the coronavirus disruption, e.g. social isolation, increased stress, run out of meds.”

Dr Bernadka Dubicka, Chair of the Faculty of Child and Adolescent Psychiatry, said: “We are worried that children and young people with mental illness who may be struggling are not getting the support that they need. We need to get the message out that services are still open for business.”

Dr Jim Bolton, Chair of the Faculty of Liaison Psychiatry, said: "Following a quieter than normal period, we are now seeing more vulnerable patients presenting in crisis. Many of these patients have suicidal thoughts or have harmed themselves. The pandemic is having a serious negative impact on people with mental illness and we are worried things could get worse."

1,369 members responded to the survey which ran from Friday 1 May – Wednesday 6 May.

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