Some A&Es 'unequipped' to cope with mental health cases, national care watchdog says

NHS and local authority services are failing to provide 'round the clock' specialist support, the report said

Charlie Cooper
Friday 12 June 2015 05:44 BST
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Ambulances at the Accident and Emergency department of St. Thomas' Hospital
Ambulances at the Accident and Emergency department of St. Thomas' Hospital (Getty)

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People suffering a mental health crisis are being treated “without warmth and compassion” by staff at some A&Es, the national care watchdog has said.

Investigators from the Care Quality Commission (CQC) found that NHS and local authority services were failing to provide “round the clock” specialist support for people feeling suicidal, suffering a psychotic episode or from extreme anxiety.

This means that many must turn to A&E services. However, only 37 per cent of patients surveyed said they felt their concerns had been taken seriously by A&E staff.

Patients who had self-harmed also encountered what inspectors called poor attitudes from A&E staff towards self-inflicted injuries.

Nearly 69,000 people were admitted to a mental health ward for urgent care in England in 2013/14. Thousands of others have suffered a mental health crisis without being admitted, and many attend A&E.

Inspectors said they had encountered instances of excellent care, with local authority, police, charity and NHS services working well together, and there has been a fall in the number of people held in police cells during a crisis.

However, Dr Paul Lelliott, the CQC’s deputy chief inspector of hospitals and lead on mental health, said that too often public services were not “equipped” to provide specialist and urgent care.

“What’s more we found that when people do receive help, hospital and mental healthcare staff are not always compassionate and caring,” he said. “…In particular, people who have inflicted harm on themselves as a result of their mental distress deserve the same respect and compassion as those whose injuries are sustained by accident.”

As part of its national review, the CQC inspected mental health crisis care in 12 areas of England, and conducted a survey of 1,800 people who had experienced a mental health crisis.

Many expressed difficulty in accessing the right service. Most said they came into contact with three different organisations during their mental health crisis. Twelve per cent came into contact with as many as six to 10 different organisations.

Making the care system easier to navigate is one priority for reform.

Paul Farmer, chief executive of the mental health charity Mind, said that services in some parts of England were “just not good enough”.

“We take it for granted that when we have a physical health emergency, we will get the help we need urgently. It should be no different for mental health, yet far too many people are just not getting the help they need,” he said.

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