Mental health patients held ‘unlawfully’ in A&Es across the country, experts warn

Mental health patients are being held “illegally” at A&E across the country, as long waits for care and beds force staff to “ride around” the law, the independent it’s been said

The University Hospital of North Midland Trust has been sanctioned by the Care Quality Commission (CQC) for holding mental health patients without any statutory authority.

However, experts have said the independent, the problem is widespread, occurring in every emergency department in the country with some patients waiting “days” and even “weeks” in A&E.

Dr. Chloe Beale, a consultant psychiatrist, said staff are being forced to “false” when it comes to laws about keeping people in A&E while they wait for ongoing mental health care.

Leaders from the Barking, Havering and Redbridge NHS Trust have raised repeated concerns in recent months about patients waiting days at their A&E for mental health care.

The CQC raised concerns about the screening of mental health patients at UHNM following an inspection in October and provided the trust with a warning notice.

In a letter seen by the independent, the CQC said two patients were “unlawfully restricted within the hospital”. He said that although staff were working in the best interest of the patient in both cases, it was clear legal procedures were “not being followed”.

“So this can be seen as a significant breach of any personal welfare,” he said.

It comes as MPs last week challenged the new mental health minister over poor access to mental health care in England during a debate in the House of Commons.

Data previously discovered by the independent revealed that the proportion of mental health patients waiting 12 hours in the ER was almost double that of all other patients.

Previous reports revealed that hundreds of children attended A&E every day for mental health issues, with some waiting in emergency departments for five days.

Barking Havering and Redbridge NHS Trust said in their board documents last week that on one day in October it had 15 people in its emergency departments, one as young as 13, waiting to be seen by mental health specialists.

Five of those patients were left waiting in the emergency department for more than two days, while one waited another 10 days to find the right bed.

Dr. Beale saidthe independent the problem of illegally detained patients happened in all hospitals.

She said: “Part of it is because of resources because we don’t have enough people to do assessments on time, people leave before an assessment or they want to leave before an assessment is complete.

“Section 136 [of the Mental health Act] expires after 24 hours, but more often than not because the bed crisis is so severe, even if you have been assessed for detention under the Mental Health Act, a bed has not been identified within that period of 24 hours. [window]. The law does not cover that gap.

She said the law doesn’t tell doctors what to do and that staff were using the Mental Capacity Act to “fill in the gaps” and “mislead you.”

Dr. Beale added, “A lot of places don’t have enough 24/7 liaison psychiatry. [capacity] however, and even those who do are so pressured that they can’t see everyone in a timely manner or can’t get to people quickly.

“There are many people waiting for psychiatric beds in emergency departments for days, sometimes weeks. So this is happening every day. It is everywhere, every day, and it is a completely hidden and illegal deprivation of liberty.”

Dr. Beale gave evidence before a House of Lords committee last week when it debated extending the use of the mental health law’s “possession powers”, which currently only apply to patients admitted to a ward , also to A&E.

However, some doctors have warned that expanding the powers would not solve the problem of scarce resources within mental health services.

Dr. Alex Thomson, a consultant psychiatrist, said The Independent: “In a mental health emergency, delays in access to beds mean that some patients in the UK may stay in the emergency department for an unreasonably long time before admission. Instead of changing the law to authorize these long waits, what is needed is enough investment in mental health services to end the delays.”

Tracy Bullock, Executive Director of UHNM, said: “Given the remarkable improvements since CQC’s last inspection and a demonstrable commitment from across the trust to ensure the best possible care for patients with mental health issues, we are disappointed that CQC has deemed necessary to withhold the formal notice after your most recent visit.

“However, we were pleased that they recognized the progress made in terms of evaluation policies and documentation and we are fully committed to working closely with them to ensure they have the security they need in relation to staff completing documentation.

“We are not a specialist mental health provider, but we take the mental health of our patients very seriously, which is why we are among the minority of acute trusts that have appointed mental health nurse practitioners. We recognize that we must continue to improve our documentation and processes to ensure that we can demonstrate that patients’ rights are protected at all times. We remain committed to making the changes necessary to demonstrate that we continue to live up to our reputation for providing safe and effective care for all.”

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