Andrew Molodynski: The mental health lottery only adds to patients' stress
FOR all the progress made in recent years on raising awareness of mental health issues and encouraging people to seek help, this is somewhat redundant when patients are left without access to necessary mental health services.
It is an issue that could come up when Prince Harry – who recently launched the Heads Together campaign to end the stigma around young people and mental health – is guest of honour at the Leeds Leads: Encouraging Happy Young Minds summit being hosted by Leeds Community Foundation today.
A BMA investigation looking into the number of out of area mental health placements across England has revealed the shocking number of patients who have to travel long distances for treatment.
The figures, provided by trusts and clinical commissioning groups in response to Freedom of Information requests, found that almost 6,000 adults were sent out of area for mental health treatment in 2016/17, a rise of almost 40 per cent in 2014/15.
With mental health services in dire need of investment, the increase in the amount of spending on out of area beds by 47 per cent from 2014-15 to 2016-17 is money that could be better spent investing in core mental health services.
In the area covered by the South West Yorkshire Partnership NHS Foundation Trust, 217 patients were placed put of area at a cost of over £3m as the average round trip for families and friends visiting patients was just under four hours by car and over five and half hours by public transport.
Similarly, in the area covered by the Leeds and York Partnership NHS Foundation Trust, 118 patients were sent out of area for treatment in costing over £4m. The average round trip by car was over three and a half hours, and almost six by public transport.
Placing patients out of area can pose a real risk to recovery as the fragmentation of care and separation from family and loved ones can make an already vulnerable patient feel more scared and isolated.
Shockingly, the investigation found that in Derbyshire, there were no NHS beds for female patients in need of intensive psychiatric care. No one should be subject to a postcode lottery when it comes to their health.
Indeed, the very process of finding a mental health bed out of area is laborious and adds undue stress to the patient.
Further complications arise when private hospitals refuse to accept a patient who has not been sectioned, as the discontinuity of care is an unnecessary stumbling block.
The lack of mental health beds is a clear example of how there must be parity of esteem between physical and mental health. A patient treated for a physical illness would not be expected to travel hundreds of miles for treatment. Why should it be any different for a mental health patient?
While Government proposals to improve community care will benefit mental health patients, it is no substitute for investment in services and resources.
Lack of funding means that many patients never have the intervention they truly need and spend years going back and forth between half-measure services while their condition worsens.
Government initiatives like the £15m pilots on mental health first aid in schools, the Think Ahead graduate programme, and the £67.7m for digital mental health services are a step in the right direction but don’t go far enough to alleviate the current pressures as services reach breaking point.
The extent to which people suffer from mental health problems is becoming more apparent. The dramatic rise in the number of young people being admitted to hospital for self-harm is further reason for the Government to address the increasing demand on mental health services.
The fast pace of modern living has brought with it unprecedented societal pressures that directly contribute to a decline in mental health. While this is perhaps typically more associated with city living, in rural Yorkshire the farming community is raising awareness of mental health issues. The move from manpower to machinery in agriculture has meant that farmers are at a greater risk of isolation as they no longer work in a community.
Out of area placements are not just an inconvenience, they can have tragic consequences. An inquest in 2016 into the death of 29-year-old David Knight, from Cornwall, found that his treatment at a hospital 150 miles away from his home was likely to have had a bearing on his death.
The Government must take urgent action to address the inadequacies in mental health treatment that are all too prevalent throughout the country.
Failure to do so will unfortunately mean that many more patients like David will fall through the cracks.
Dr Andrew Molodynski is a NHS consultant psychiatrist and the British Medical Association’s consultants committee mental health policy lead.