To be shocked at this episode of hospital

[User4544]

A lady who had attempted to take her own life was waiting a number of days for a mental health bed. There were none available either privately or in other nhs trusts. Is this common place for there to literally be no beds?

When I moved to work in mental health services in England (from elsewhere in Uk) in 2007, they were in a relatively good state of funding and service development. Not great as no one ever prioritises spending on mental health but when I look back now god what we were actually able to offer people.

From 2010 and the Coalition government bringing in austerity, things have sharply and continued to deteriorate in mental health services in England. Leaving social care funding aside (v tired), most NHS services were expected to make ‘efficiency’ savings of 4% per year but most mental health trusts were expected to make 8% ‘savings’ per year.

For savings read cuts.

For efficiency read ideology.

None of it made any bastard difference to the bastard public purse in the way the Cameron and Osborne and all those gaping grasping arseholes sold it as a narrative to the public via the media, eg reducing national debt just like you or I would reduce household debt.

Liars.

Mental health services are devastated and will take billions of properly protected allocated monies to rebuild the actual services and the staff expertise lost.

Nothing can repay or replace the suffering and lives lost because the people who need to use mental health services cannot.

I sincerely hope the state of constant simmering rage ends up inducing superpowers instead of heart disease or cancer so I can live the dream of actually shooting lasers out of my eyes, making testicles drop right off, adults shrink to 1 inch, etc ( I am told I give off these vibes when cross 😂) I would have such larks with current and former inhabitants of House of Commons...

[quote ghghyty]@ChakaDakotaRegina this is true. My partner is a police officer and spends so much of his time dealing with people who need MH help. They're not criminals, just ill. You'd think a typical weekend nightshift would be spent patrolling the town centre dealing with crime when in reality it's spent in hospitals looking after the mentally ill or searching for missing people who are only missing because they have not had the help they desperately need.

@Highlightninga it's not about the police not liking it. It's about the general public being under the impression police are out there fighting crime when in reality they are doing a job that should be done by a mental health team.

He comes home after a night of a looking after a suicidal 17 year old female and asks what the fuck do I know about helping a suicidal person? My heart sinks for both of them. The young woman deserves actual help and the police officers deserve to do the job they are trained for.[/quote]
My point is though that there is an assumption that the mental health team should be doing it when in reality its the police that hold the legal powers and responsibilities.

If a mental health team attends someone's house they have no powers of entry, no powers of removal. My mental health team often gets asked to respond to emergencies in public places, but we would for example have to call the police as we would need possibly the power of being able to section someone . Equally we lack the power to do welfare checks as the ability to over ride consent to share, track down relatives, force entry or do specific searching like tracing cars or phones. If someone called us in an emergency eg like that suicidal person we could only ask that the person attends hospital and would have no power to take them, and would have to hope they answer the door

It’s incredibly frustrating.
Crisis teams ‘gate keep’ inpatient beds so have to sign off all admissions. Often, there are no beds available. And the crisis teams get called useless for not doing more.
Everywhere is so understaffed and underfunded.
I’m working night shifts this week in a crisis team. 2 staff covering a huge area including A&E assessments and answering a 24 hr support line which rings constantly.
Yes, we need the police to help sometimes because an average night has 5-6 assessments in A&E and peoples homes so sometimes we cannot respond to urgent calls in time to keep people safe so we ask the police to support us.

As for calling 999... unless there is a life threatening emergency this should not be considered appropriate to get a MH assessment. In the end, they’ll be brought to A&E and join the queue to be seen by the crisis team who will decide if they need admission or not. There is no bypassing that. 999 emergency services cannot arrange MH admissions!

It’s dire but MH services can only work with what we have available to us. We cannot magic up more staff or beds to meet need. But we get the brunt of all the criticism and called shit. Constantly.

@MeAndHimAndHer the thing is while the individuals who work in mental health are mostly good people and trying their best, it doesn't change the fact that mental services are shit. Nobody should be getting sent home after a suicide attempt (that they have been begging for help preventing for months) with promises of support that never arise. I have been begging and begging anyone who might listen to me for months and getting absolutely nowhere, all I got was kicked off mumsnet for reaching out on here because nobody else listening (I understand that I was in a bad place but at the time it felt very much like being kicked when I was down). I have not heard a single peep from anyone since I was discharged, I have rung the crisis team multiple times since then and I'm still not getting any help. I have given up, I don't think I can keep myself safe, I don't think it will be all that long before I'm in another crisis and I don't think I will ring anyone this time because there's no point and all they do is threaten social services involvement because I have young children.

I understand that you can only work with what you have available to you, but people are scared and frustrated and when you are so ill and you know you are ill and being told that your not ill enough and you deserve help is hard. I have broken down to staff so many times and they've had no sympathy whatsoever. I have been made to feel that ito be Frank nobody would care if I did die because then at least I'm one less person in the queue.

*that you don't deserve help.

No surprise to me. Surprised you are surprised.
The conservatives lack of funding of NHS and particularly MH, over many years, more people are starting to notice.

No surprise. What gets me is the knock on impact re attitude to suicidal idealisation. Under cahms it’s almost as if they’re not interested until they’ve actively tried. It’s appalling.

It’s great that this has been highlighted on the Hospital program, but much more publicity about this national disgrace is needed.

I knew it was bad but had no idea it was that bad.

It's even worse for children and young people. The number of times we have teenagers on an acute paediatric ward, for weeks at a time, their serious mental health needs unmet, because there's no specialist CAMHS bed available.

Absolutely! I know from personal family experience, infact it has been so poorly funded for years and years that I changed which degree I was doing because I couldn't work in an environment where I knew someone could potentially kill themselves because of lack of funding

Some of the beds on the computer system have two people assigned as one might be allowed home over night or for two nights so they immediately use that bed. It's fire fighting and there just isn't enough funding.

@Talkwhilstyouwalk

I've been told that the best thing you can do in a mental health crisis is to call 999 for an ambulance. Far more likely to get a bed that way than if you go via gp etc.

Absolutely untrue. This does not magic up beds that do not exist.

Yes getting a mental health bed is extremely difficult. Its a very unfunded service sadly

Yep my mum works in mental health and had a patient admitted. Only for him to have to travel from Manchester (his home) to Bristol because that's where the nearest bed was.

im sure the lady in the programme was back home within a week,i was shocked and thats why i remembered it

I attempted suicide. I was taken by ambulance to a&e, I saw a lovely doctor who was really caring and understanding. The nurse I saw dismissed me as an attention seeker. I had to wait 9hrs for a psych assessment and was told there were no beds and to go home (I went home and suffered weeks of awful side effects from the attempt). They said they would send me a letter for urgent referral to psychiatry, within 7 days.

That was 7 years ago and I’m still waiting for the letter. If I hadn’t had a family willing to pay for a private psychiatrist I would never have got treatment.

If there are no beds then there are no beds

Mental health services cannot improve without adequate funding and priority
We are second best and disadvantaged to physical health services all the time

If a ward or a unit is slated to be closed at the physical hospital there are protests in the street. Mental health that never happens so it's easy to make cuts.

If you are delayed discharge in an acute hospital bed social care have to pay for the bed. For many years that was not the case in mental health so they had zero incentive to help us to discharge and free up beds. Now it is theoretically possible to be delayed discharge but the Dr cannot just say it's so. It has to actually be agreed by a panel that the person is delayed and they will use any excuse they can not to fund.

If you have been detained under MHA then eventually someone will find you a bed. If not then it will be very hard to get one in the current climate. Bed numbers were low anyway and have been reduced because of needing to make Covid isolation areas.

Lockdown has caused an absolute tsunami of need that we are only just seeing coming through. It's a Cumulative impact of routine support services that kept people well being withdrawn plus isolation, job loss, bereavement, chronic illness all risk factors that are increasing.

I love my job. I care greatly about my patients but I cannot do any more than I am doing and there is a tonne of unmet need out there that will not be met without funding. Decades of people voting for a Tory government do this.

Also it's not all about beds or 'mental health services'. We are left to carry the can for all of societies ills it sometimes seems. Bad relationships, abusive parenting, bullying, poverty, poor housing, exploitative employers, benefit cuts, immigration issues. All of these can lead to a 'mental health crisis' but few can be solved by an inpatient psych admission or a few pills. Schizophrenia or mania I know how to treat but the range of adjustment disorders, conduct disorder, personality disorders, neurodevelopmental disorders that are all just 'psych' now are a lot harder and more expensive and long term to address. If society expects us to provide care and treatment for all those things as well as severe enduring (mainly psychotic) mental illness which was the bread and butter stuff in the past then we nee to be funded to do it.

Yep, all the time. We have a number of teenagers waiting for beds. Sometimes for weeks or months in acute hospital beds. Apparently it gets escalated but it never changes. We frequently have patients sectioned on the ward, they often beat up the staff and cause damage. We aren’t trained to deal with it, we aren’t mental health nurses, we are paediatric nurses. The situation is diabolical. I couldn’t tell you what CAMHS do.

Then, when a placement is found they refuse to take them so it’s back to square one again. Some teenagers are placed 100s of miles away.

Waiting a number of days is nothing.

Not watched it (and in my current state of mind, sounds I'd best avoid), but I am not surprised.

A common misconception is that suicide attempt = psych ward admission. If you are suicidal because you have lost your job and are in huge debt, an admission wont help with that.

A PP said about calling 999 for a better chance of a bed. Um no, it does not work like that. A&E is terrible for mental health issues. Is ok if you need actual physical medical help, but they can't do fuck all for anything else and can be dismissive at times. I have had some awful comments from A&E staff.

Saying that, when I have been assessed, I have been lucky and got admitted straight away. Waiting a few hours tops for a bed. That is not the norm though, not by a long stretch.

And the fact is, without beds for those in crisis, people die. My mum committed suicide 3 years ago today, at least in part because the community mental health nurse told her not to come for her appointment that day as the clinic was too busy, promised to come and do a home visit at the end of the day, and then didn't, after making no attempt to contact her and advise she wasn't coming. Obviously my mother had significant existing mental health issues of long standing; but this act of callousness by the person who was meant to be keeping her sane was the straw that broke the camel's back. It told her she was worth nothing, that nobody cared that she was openly suicidal, that no-one was coming to help and that she didn't even deserve an apology or an explanation.

Mental health services in this country are absolutely on their knees from government underfunding and neglect (and more generally from this government's policies which give rise to exactly the kind of circumstances - atomisation, isolation, poverty - that foster and exacerbate mental illness to the point even an adequately funded service would struggle to cope with the rise in need for treatment).

Today i ate croissants with extra butter and apricot jam the way my mother taught me, tried to remember her big loud fuck 'em laugh and her catchphrases, tried to focus on the light of her life and not how she came to die. Because if I think about that too much, all the circumstances that led to that final decision fill me with such a combination of anger, bitterness and self-blame I can't be a mother to my own children, can't function at all.

The traumatic bereavement has given me mental health issues in turn which I will struggle not to pass on to my own daughters.

Its shocking and an area that needs investment, I know of someone who self harmed so badly but they were stiched up and sent home without any support offered.

It is sadly common for no beds to be available. Sometimes people are declined by private hospitals even if beds are available, be it due to risks, age, co-morbidities. Often private hospitals won’t take our older patients.

I work in older adults inpatient MH and we work at 100% bed capacity at all times, there is always patients waiting to come in. They wait at home, often supported by Crisis team, in General hospital beds, in A&E, it psychiatric decision units…..it’s not ideal but if we don’t have beds, we don’t have them.

Increase in people needing to access the service and a reduction in beds available. I have never seen so many people coming in as has been the case over the last few years.

@Coldwine75

Its shocking and an area that needs investment, I know of someone who self harmed so badly but they were stiched up and sent home without any support offered.

Self harm is something that needs long term support though. A&E can't offer that, or even sign post you.